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COPYRIGHT DEPOSIT 



DISEASES OF 

CATTLE, SHEEP, GOATS 
AND SWINE 



G. MOUSSU 

Professor at the Veterinary College of Al fort; Doctor of Medicine, 
Doctor of Science, etc. 



AND 

JNO. A. W. DOLLAR, M.R.C.V.S., F.R.S.E., M.R.I. 

President of the Royal College of Veterinary Surgeons; Vice-President of the Royal 

Institute of Public Health; Corresponding Member of the Central Society of 

Veterinary Medicine of Paris; Associate of the Society of Veterinary 

Medicine of Brabant {Belgium); Life Member of the Royal 

Italian Society of Hygiene, etc. 




NEW YORK 

WILIvIAM R. JENKINS 
VETERINARY PUBLISHER AND BOOKSELLER 

851 AND 853 Sixth Avenue 

1905 
\_All Rights Reserved^ 



fwo Copies (ieo^ivitMJ 

AUG 14 1905 
CQpv a. I 



i«-.^^' 



^r 



Copyright, 1905, by William R. Jenkins 



All Rights Reserved 



PREFACE. 



No apology seems called for in presenting to English-speaking 
veterinary surgeons and students a treatise on the diseases of 
cattle. To those entrusted with the onerous task of preventing or 
curing disease in cattle, sheep and swine the scantiness of 
permanent literature dealing with the subject must always have 
proved a matter of some embarrassment, while to teachers and 
students alike the want of a concise and modern text-book has 
long been a difficulty of the first order. It is hoped that the 
present volume may go some way towards remedying this state of 
affairs. 

As on previous occasions, the writer has freely availed himself 
of foreign sources of information. Two years ago he purchased 
the literary rights in Professor Moussu^s " Maladies du Betail,^' 
which had even then attained an European reputation, and which 
forms the backbone of the present volume. To obtain further 
information, the more important German treatises have been laid 
under contribution, while all accessible English, American, and 
Colonial literature of recent date has been referred to. (The 
references practically extend up to the moment of writing — the 
latest being June, 1905.) In this way the work may in some 
degree claim to have assumed an international character. The 
extent of the additions is indicated by an increase in the number 
of illustrations of 140, and of the text of nearly 50 per cent. 

Professor McQueen has performed the greatly- valued service 
of reading proof-sheets and advising the writer as the book passed 
through the press. 

To Dr. Salmon, of the United States Department of Agri- 
culture, special thanks are due for his generous permission to 
quote from the annual reports of that body. 

Other acknowledgments will be found in the text. 



VI PREFACE. 

Once again the writer, who on this occasion chances also to be 
the President of the Royal College of Veterinary Surgeons, appeals 
for lenient judgment on work performed under no common stress 
of duties, professional and political. 

JNO. A. W. DOLLAR. 



CONTENTS. 



CHAP 



PAGE 



SECTION I. 

DISEASES OF THE OEGANS OF LOCOMOTION. 

Methods of Examination 1 

I. DISEASES OF BONES 3 

General Diseases 4 

Eachitis • . . . 4 

Osseous Cachexia ......... 7 

Local Affections . • .20 

Fractures ........... 20 

Fractures of the horns 21 

Detachment of the horns 23 

Eissuring of the horns 24 

Fractures of the horns ........ 25 

Exostoses 27 

Spavin in the ox. . . . . . . . . .27 

Eing-bone ........... 28 

Suppurating ostitis ......... 29 

Bone tumours .......... 30 

II. DISEASES OF THE FOOT ......... 31 

Congestion of the Claws . . . . . . . .31 

Contusions of the sole . . . . . . . .31 

Laminitis . . . . . . . . . . .32 

Sand crack ........... 34 

Pricks and stabs in shoeing ........ 36 

Picked-up nails, etc. ("Gathered nail") . . . . .37 

Inflammation of the interdigital space (Condylomata) ... 38 

Canker 40 

Grease ........... 41 

Panaritium — Felon — Whitlow , , . . . . .41 

Foot rot 43 

III. DISEASES OF THE SYNOVIAL MEMBRANES AND OF THE 

AETICULATIONS 45 

I. Synovial Membranes and Articulations .... 45 

Synovitis ........... 45 

Inflammation of the patellar synovial capsule . , , , 45 



VIU 



CONTENTS. 



CHAP. 

III. 



DISEASES OF THE SYNOVIAL MEMBBANES AND OF THE 

A^TlCVLATlOl^^S—conthiued. 

I. Synoyial Membranes and Articulations — continued. 

Distension of the synovial capsule of the hock joint 
Distension of tendon sheaths in the hock region 
Distension of the synovial capsule of the knee joint 
Distension of the synovial capsule of the fetlock joint 
Distension of tendon sheaths 

Distension of tendon sheaths in the region of the knee 
Distension of the bursal sheath of the flexor tendons 
Traumatic synovitis — " Open synovitis" 
Traumatic tendinous synovitis 
Traumatic articular synovitis — Traumatic arthritis • — ' ' Open 
arthritis " 

II. Strains or Joints 

Strain of the shoulder 

Strain of the knee 

Strain of the fetlock 

Strain of the stifle joint 

Strain of the hock joint . . . 

III. Luxation of Joints 
Luxation of the femur 
Luxation of the patella 
Luxation of the femoro-tibial articulation 
Luxation of the scapulo-huraeral joint 

lY. Hygromas 

Hj^groma of the knee .... 

H^^groma of the haunch 

Hygroma of the trochanter of the femur 

Hygroma of the stifle 

Hygroma of the point of the hock 

Hygroma of the point of the sternum . 



(Biceps femoris) 



lY. DISEASES OF AiUSCLES AND TENDONS 

Eupture of the external ischio-tibial muscle 
Eupture of the flexor metatarsi . 

Parasitic Diseases of Muscles 
Cy^sticercus disease of the .pig 
Beef measles ..... 

Trichiniasis — Trichinosis 



Y. EHEUMATISM 

Articular rheumatism 
Muscular i^heumatism 

Infectious Forms of Eheumatism or Pseudo-rheumatism 
Infectious rheumatism in j^oung animals . . . . 

Infectious pseudo-rheumatism in adults .... 
Scurvy — Scorbutus . 



CONTENTS. 



IX 



SECTION II. 



DISEASES OF THE DIGESTIVE APPAEATUS. 



Semiology of the Digestiye Apparatus 



I. DISEASES OF THE MOUTH 



Stomatitis ...... 

Simj)le stomatitis .... 

Catarrhal stomatitis in sheep 
Necrosing stomatitis in calves 
Mycotic stomatitis in calves . 
Ulcerative stomatitis in sheep 
General catarrhal stomatitis in swine 
Ulcerative stomatitis in swine 
Mercurial stomatitis 

Glossitis ...... 

Superficial glossitis 
Acute deep-seated glossitis , 
Chronic glossitis .... 



PAGE 
106 

121 
121 
121 
122 
123 
124 
125 
126 
127 
128 

130 
130 
131 
132 



II. 



DISEASES OE THE SALIVAEY GLANDS, TONSILS AND 
PHAEYNX .134 



Parotiditis (Parotitis) ..... 

Acute parotiditis ..... 

Chronic parotiditis —Parotid fistula 
Inflammation of the submaxillary salivary gland 
Tonsilitis in pigs ...... 

Pharyngitis ....... 

Pseudo-membranous pharyngitis in cattle 

Pseudo-membranous pharyngitis in sheep 
Pharyngeal polypi ' 



III. DISEASES OF THE CESOPHAGUS 



CEsophagitis ...... 

Stricture of the oesophagus .... 

Dilatation of the oesophagus 

Oesophageal obstructions .... 

Euptures and perforations of the oesophagus 



IV. 



134 

134 
136 
137 
138 
138 
141 
142 
143 

145 

145 
148 
149 
152 
157 



DEPEAVED APPETITE— THE LICKING HABIT— INDIGESTION 158 

Depraved appetite in the ox. . . . . . . .158 

Depraved appetite in calves and lambs . . . . .160 

Colic in the ox 162 

Colic due to ingestion of cold water — Congestive colic . . 162 
Colic due to invagination . . . . . . .163 

Colic as a result of strangulation . . . . , .167 

Diseases of the stomach . . . . . . . .169 

Indigestion . .......... 170 

Gaseous indigestion . . . . . . . .170 



CONTEiNTS. 



CHAP. PAGE 

IV. DEPEAVED APPETITE— THE LICKING HABIT— INDIGESTION 

— continued. 

Indigestion — contin ued. 

Impaction of the rumen — Indigestion as a result of over- 
eating . . . ' . . . . . . .175 

Impaction of the omasum (third stomach) 
Abomasal indigestion ...... 

Acute gastric indigestion in swine 



GASTEIC 

-Gastritis 



COMPAETMENTS 



Y. INFLAMMATION OF THE 

Eumenitis — Eeticulitis- 
Acute gastritis 
Catarrhal gastritis in swine 
Ulcerative gastritis 
Chronic tympanites 

Gastric disturbance due to foreign bodies 
Tumours of the gastric compartments 

VI. ENTEEITIS ...... 

Acute enteritis .... 

Hsemorrhagic enteritis 

Chronic enteritis (Chronic diarrhoea) 

Dysentery in calves 

Diarrhoeic enteritis in calves 

YIL POISONING 

Poisoning due to food . 

Poisoning by caustic alkalies 

Poisoning by caustic acids . 

Poisoning by common salt . 

Poisoning by the nitrates of potash and soda 

Poisoning by tartar emetic . 

Poisoning by arsenic . 

Phosphorus poisoning . 

Mercurial poisoning 

Lead poisoning : Saturnism . 

Copper poisoning . 

Carbolic acid poisoning 

Poisoning by aloes 

Iodoform poisoning 

Iodine poisoning : iodism 

Strychnine poisoning , 

List of plants poisonous to stock 

Colchicum poisoning . 

Poisoning by annual mercury 

Poisoning by bryony . 

Poisoning by castor oil cake 

Poisoning by cotton cake 

Poisoning by molasses refuse 

Diseases produced by distillery and sugar factory pulp 

YIII. PAEASITES OF THE DIGESTIYE APPAEATUS . 

Gastro-intestinal strongylosis in sheep 

Lumbricosis of calyes .,,,,,. 



CONTENTS. XI 

CHAP. PAGE 

VIII. PAEASITES OF THE DIGESTIVE A-PFAUATVS—contmued. 

Strongylosis of the abomasum in the ox . . . . .268 
Parasitic gastro-enteritis, diarrhoea, and anaemia in cattle, sheep 

and lambs 268 

Intestinal coccidiosis of calves and lambs (Psorospermosis, haemor- 

rhagic enteritis, bloody flux, dysentery, etc.) . . . .271 
Intestinal helminthiasis in ruminants . . . . . .275 

IX. DISEASES OE THE LIVER 279 

Congestion of the liver 280 

Nodular necrosing hepatitis . . . . . . .280 

Cancer of the liver and bile ducts . . . . . . 282 

Echinococcosis of the liver . . . . . . . .283 

Suppurative echinococcosis ........ 288 

Cysticercosis . , . . . . . , . .290 

Distomatosis — Liver fluke disease — Liver rot .... 293 

SECTION III. 

EESPIKATORY APPARATUS. 
I. EXAMINATION OE THE EESPIEATOEY APPAEATUS . .311 

IL NASAL CAVITIES 319 

Simple coryza 319 

Gangrenous coryza . . . . . . . . .320 

Tumours of the nasal cavities ....... 325 

Purulent collections in the nasal sinuses. Nasal gleet . . 326 

Purulent collections in the frontal sinus . . . . . 327 

Purulent collections in the maxillary sinus ..... 329 

CEstrus larvse in the facial sinuses of sheej) ..... 330 

III. LAEYNX, TEACHEA AND BEONCHI 333 

Laryngitis ........... 333 

Acute laryngitis 333 

Pseudo-membranous laryngitis . . . . . . 333 

Tumours of the larynx . . . . . . .335 

Bronchitis . . • 336 

Simple acute bronchitis ....... 337 

Chronic bronchitis . . . . • . . .337 

Pseudo-membranous bronchitis ...... 339 

Verminous bronchitis in sheep and cattle (Plusk, hoose, etc.) 340 

IV. LUNGS AND PLEUE^ 343 

Pulmonary congestion . . . . . . . . .343 

Simple pneumonia ......... 343 

Pneumonia due to foreign bodies — Mechanical pneumonia . . 347 
Pneumonia due to the migration of foreign bodies from the 
reticulum .......... 348 

Pneumomycosis due to Aspergilli ' . . . . . .350 

Gangrenous broncho-pneumonia due to foreign bodies . . 351 

Infectious broncho-pneumonia ....... 354 

J^roncho-pneumonia of sucking calves ,,.,., 396 



Xll 



CONTENTS. 



CHAP. PAGE 

ly. LUNGS AND TI.'EVnM— continued. 

Sclero- caseous bronclio -pneumonia of sheep .... 858 

Pulmonary emphysema . . . . . . . .359 

Diseases of the pleura . . . . . . . .861 

Acute pleurisy 361 

Chronic pleui'isy . . . . . . . . . 362 

Pneumo-thorax . . . . . . . . . . 362 

Hydro-pneumo-thorax and pyo-pneumo-thorax . . . 366 

Y. DISEASES OF STEUCTURES ENCLOSED WITHIN THE MEDI- 
ASTINUM . 368 

Tumours of the Mediastinum ....... 369 



SECTION lY. 

THE OKGANS OF CIKCULATION. 



Semiology of the Oegans of Circulation 



CAEDIAC ANOMALIES 

Ectopia of the heart 



II. PEPICAEDITIS 

Exudative pericarditis due to foreign bodies 
Chronic pericarditis .... 
Pseudo -pericarditis .... 



III. ENDOCARDITIS 

ly. DISEASES OE BLOOD-YESSELS 

Phlebitis 

Accidental phlebitis .... 
Internal infectious phlebitis (Utero- ovarian 
Umbilical phlebitis of new-born animals 
Umbilical phlebitis or omphalo-phlebitis 



Y. DISEASES OF THE BLOOD 



Septicaemia of new-born animals 

Takosis : a contagious disease of goats 

Blood-poisoning (Malignant oedema) in sheep and lambs in 

Zealand ..... 
Piroplasmosis .... 

Bovine piroplasmosis 

Bovine piroplasmosis in France 

Ovine piroplasmosis 
Diseases produced by trypanosomata 
Louping-ill .... 

Suggested measures for prevention 
Braxy . . . . • 

Bilharziosis in cattle and sheep . 
Heat stroke — Over-exertion 



phlebitis) 



New 



370 

374 
374 

375 

376 

389 
390 

394 

396 

396 
396 
398 
399 
402 

406 

406 
412 

415 
416 
416 
424 
425 
426 
429 
435 
435 
439 
442 



CONTENTS. Xlll 
CHA?. PAGE 

YI. DISEASES OF THE LYMPHATIC SYSTEM 444 

The lymphogenic diathesis ......... 448 

Caseous lymphadenitis of the sheep ...... 453 

Goitre in calves and lambs ........ 453 

SECTION V. 
NERVOUS SYSTEM. 

Cerebral congestion ......... 456 

Meningitis ........... 456 

Encephalitis .......... 458 

Cerebral Tumours ......... 459 

Insolation 460 

Post-partum paralysis — Milk fever — Mammarj^ toxaemia — Par- 
turient apoplexy — Dropping after calving . . . . -^61 

Coenurosis (Gid, sturdy, turn-sick) ...... 467 

" Trembling," or Lumbar prurigo, in sheep .... 475 

SECTION YI. 

DISEASES OF THE PERITONEUM AND ABDOMINAL 

CAVITY. 

I. PEEITONITIS 478 

Acute peritonitis . . . . . . . . . . 478 

Chronic peritonitis . . . . . . . . . 481 

Ascites . • 483 

Peritoneal cysticercosis . . . . . . . .485 

11. HEENI^ 487 

Congenital hernise . . 487 

Perineal hernia of young pigs . ... . . . 487 

Umbilical hernia ......... 488 

Acquired hernise .......... 489 

Hernia of the rumen 490 

Hernia of the abomasum ........ 493 

Hernia of the intestine . . . . . . . . 494 

Treatment of hernise . . . . . . . . . 495 

Diaphragmatic hernia . . . . . . . . . 496 

Eventration . . 499 

Eistulae of the digestive apparatus ...... 500 

SECTION YII. 

GENITO-UEINAEY REGIONS. 

Diseases of the Urhstaiiy Apparatus 502 

1. POLYPI OF THE GLANS PENIS AND SHEATH . . .506 

Inflammation of the sheath ........ 506 

Persistence of the urachus ........ 508 



XIV 



CONTENTS. 



CHAP. 

II. DISEASES OF THE BLADDEE 

Acute cystitis .... 
Chronic cystitis .... 
Urinary lithiasis. Calculus formation 

Calculi in bovine animals 

Urinary calculi in sheep 
Paralysis of tlie bladder 
Eversion of the bladder 
Hsematuria . . . 

III. DISEASES OF THE KIDNEYS 

Congestion of the kidneys 

Acute nephritis . 

Chronic nephritis . 

Hydro -nephrosis . 

Infectious pyelo-nephritis 

Suppurative nephritis and perinephritis 

The kidney worm {ScJerostoma pingmcola) of swine 

IV. GENITAL APPAEATUS 

Vaginitis 

Acute vaginitis 

Contagious vaginiti 

Croupal vaginitis 

Chronic vaginitis 
Metritis 

Septic metritis 

Acute metritis 

Chronic metritis 
Epizootic abortion in cows 
Salpingitis — Salpingo -ovaritis 
Torsion of the uterus . 
Tumours of the uterus . 
Tumours of the ovary . 
Genital malformations . 

Imperforate vagina 
Nympho-mania . 

V. DISEASES OF THE MAMMAEY GLANDS 

Physiological anomalies 
Wounds or traumatic lesions 

Chaps and cracks . 
Milk fistulse . 
Inflammatory diseases . 

Congestion of the udder 
Mammitis 

Acute mammitis 

Contagious mammitis in milch cows 

Chronic mammitis 

Gangrenous mammitis of milch ewes 

Gangrenous mammitis in goats 



CONTENTS. 



XV 



CHAP. 

y. 



yi. 



DISEASES OF THE MAMMAEY GT.A'NBS— continued. 

Cysts of the udder ......... 

Tumours of the udder ......... 

yerrucous papillomata of the udder ...... 

DISTUEBANCE IN THE MILK SECEETION AND CHANGES 
• IN THE MILK 

Microbic chanses in niilk. Lactic ferments .... 



yil. MALE GENITAL OEGANS 
Tumours of the testicle 
Accessory glands of the genital apparatus 



PAGE 

585 
585 
586 

587 
588 

594 
594 

597 



SECTION YIII. 

DISEASES OF THE SKIN AND SUBCUTANEOUS 

CONNECTIYE TISSUE. 

I. ECZEMA 

Acute eczema . . . 
Chronic eczema ..... 
Sebaceous or seborrhoeic eczema . 
Eczema due to feeding with potato pulp 
Impetigo in the pig .... 
Acne in sheej) ..... 



II. PHTHIEIASIS 



ScAEiES— Scab— Mange 



dip 



Scabies in sheep . 
Sar Coptic scabies 
Psoroptic mange — Sheep scab 
The tobacco and sulphur 
Lime and sulphur dips 
Arsenical dips 
Carbolic dips . 
Chorioptic mange — Symbiotic mange- 
Mange in the ox . 
Sarcoptic mange 
Psoroptic mange 
Chorioptic mange 
Mange in the goat 
Sarcoptic mange 
Chorioptic mange 
Mange in the pig . 
Demodecic mange 

Demodecic m.qno:e 



Demodecic mange 



in the ox 
in the goat 
Demodecic mange in the pif 
Non-psoroptic forms of acariasis 
Hypodermosis in the ox (warbles) 



Eoot 



scab 



599 

599 
600 
601 
603 
605 
606 
608 

60S 
611 
611 
612 
614 
626 
627 
632 
633 
636 
638 
638 
639 
640 
641 
641 
642 
642 
643 
644 
644 
644 
645 
64^ 



Xvi CONTENTS. 

CHAP. PAGE 

III. EINGWOEM 649 

Eingworin in the sheep, goat, and pig ...... 653 

IV. WAETS IN OXEN . . . . . . . . . .655 

Urticaria in the pig . . . . . . . . .656 

Scleroderma . . . . . . . . . . 657 

y. SUBCUTANEOUS EMPHYSEMA 659 

SECTION IX. 

DISEASES OF THE EYES. 

Foreign bodies . . . . . . . . . . 661 

Conjunctivitis and keratitis ........ 662 

Verminous conjunctivitis , , . . . - . . . 662 

Verminous ophthalmia of the ox . . ■ . . . . . 663 

SECTION X. 
INFECTIOUS DISEASES. 

Cow-pox — Vaccinia ....... 

Cow-pox and human variola— Preparation of vaccine 

Tetanus 

Actinomycosis . ... 

Actinomycosis of the maxilla 
Actinomycosis of the tongue . 
Actinomycosis of the pharynx, parotid 
Tuberculosis . . . . 

Tuberculosis of the respiratory apparatus 

Tuberculosis of the serous membranes 

Tuberculosis of lymphatic glands . 

Tuberculosis of the digestive tract 

Tuberculosis of the genital organs 

Tuberculosis of bones and articulations 

Tuberculosis of the brain 

Tuberculosis of the skin 

Acute tuberculosis — Tuberculous septicaemia 
Swine fever — Verrucous endocarditis and pneumonia of the pig 

Swine fever . . . . . . . ■ . 

Verrucous endocarditis of the pig ..... 

Pneumonia of the pig ....... 

Hsemorrhagic septicaemia in cattle ..... 



665 
669 
670 
672 
673 
674 
675 
682 
690 
694 
696 
699 
700 
701 
702 
703 
7C4 
710 
710 
713 
714 
716 



SECTION XL 

OPEEATIONS. 

I. CONTEOL OF ANIMALS 720 

Control of oxen 720 

Partial control 720 

Control of the limbs . . . . , . . .720 



CONTENTS. 



XVll 



CHAP. 

I. CONTROL OF ANlMAIjS—contmued. 
Control of oxen — continued. 

General control 

Control by casting 
Control of sheep and goats 
Control of pigs 
Anaesthesia . 

II. CIRCULATOEY APPAEATUS 

Bleeding 

Bleeding in sheep . 

Bleeding in the pig 
Setons, rowels, plugs, or issues 

III. APPAEATUS OP LOCOMOTION 

Surgical dressing for a claw .... 

Amputation of the claw or of the two last phalanges 

lY. DIGESTIYE APPAEATUS 

Ringing pigs 

CEsophagus ....... 

Passing the probang .... 

Crushing foreign bodies in the oesophagus 

CEsophagotomy ..... 

Sub-mucous dissection of the foreign body 
Eumen ....... 

Puncture of the rumen .... 

Grastrotomy ....... 

Laparotomy ....... 

Herniee ........ 

Inguinal hernia in young pigs 

Imperforate anus ..... 

Prolapsus and inversion of the rectum . 

Y. EESPIEATOEY APPAEATUS .... 

Trephining the facial sinuses 

Trephining the horn core ... 

Prontal sinus 

Maxillary sinus ..... 

Tracheotomy . . . . , . 

YI. GENITO-UEINAEY OEGANS .... 

Urethrotomy in the ox . . . 

Ischial urethrotomy .... 

Scrotal urethrotomy .... 
Passage of the catheter and urethrotomy in the i 
Passage of the catheter in the cow 
Castration ....... 

Castration of the bull and ram 

Bistournage . 

Martelage 

Castration by clams 
D.C. 



722 
723 
725 
725 
726 

727 

727 
727 
728 
728 

730 

730 
730 

734 

734 
734 
735 
735 
736 
736 
737 
737 
739 
740 
741 
741 
742 
743 

745 

745 
745 
745 
745 
746 

747 

747 
747 
748 
749 
750 
751 
751 
751 
756 
756 



XVlll 



CONTENTS. 



CHAP. 

VI. 



GENITO-URINAEY 0'RGA'NS—co?itmued. 
Castration — continued. 
Castration by torsion 
Castration with the actual cautery 
Castration by the elastic ligature . 
Castration of the ram . 
Castration of boars and young pigs 
Castration of cryptorchids 
Female genital organs . 
Castration of the cow . 
Castration of the sow . 
Suture of the vulva 
Trusses .... 

Section of the sphincter of the teat 
Dilatation of the orifice of the teat 
Ablation of the mammae 



757 

758 
758 
759 
759 
760 
760 
761 
765 
768 
769 
770 
770 
771 



DISEASES OF CATTLE, SHEEP, 
GOATS AND SWINE. 

SECTION I. 
DISEASES OF THE ORGANS OF LOCOMOTION, 

METHODS OF EXAMINATION> 

Accidental and local diseases of the apparatus of locomotion are 
matters of less m'genc}^ in the case of cattle than in that of the horse. 
On the other hand, general affections, such as rheumatism and osseous 
cachexia, demand a larger share of attention, and are of the utmost 
importance. 

As the accurate diagnosis of any disease demands careful and 
systematic examination, the practitioner usually observes a certain 
order in his investigations, as indicated below : — 

(1.) Inspection, from the side, from the front and from behind, re- 
veals the existence of deformities of bones, limbs, muscles and joints, 
articular displacements, and irregularities of conformation or of gait. 

By inspection of an animal as it walks various forms of lameness, and 
their particular characteristics, are rendered visible. 

(2.) Palpation and pressure ^Yill detect changes in local sensibility, 
the softness or hardness of tissues, the existence of superficial or deep 
fluctuation, oedematous s^yelling, and abnormal gro^Yths like ring-bones 
and exostoses, as well as the exact character of articular enlargements. 

(3.) Percussion is of little value in examining tlie apparatus of loco- 
motion. Nevertheless, percussion of the claws, and of certain bones of 
the limbs, or of flat bones, may afford valuable information in cases of 
laminitis, ostitis, and periostitis. Percussion along the longitudinal 
axes of the limb bones is also useful in diagnosing intra-articular frac- 
tures, sub-acute arthritis, osteomyelitis, etc. 

(4.) The gait. Lame animals should be made to move, in order to 
assist both in discovering the cause, and in estimating the gravity of the 
condition. Sometimes it is advisable to turn the animal loose, but most 
frequently it is moved in hand, either in straight lines or in circles. 

D.C. B 



2 . DISEASES OF THE ORGANS OF LOCOMOTION. 

Information so obtained should always be supplemented by local 
manijDulation and by passive movement, such as flexion, extension, 
abduction, adduction and rotation of the joints. 

A knowledge of the characteristics of normal movement in any given 
joint, renders it comparatively easy to detect abnormality, such as 
increased sensibility, articular crepitation or friction, and to diagnose 
fractures with or without displacement, ruptures of tendons or 
ligaments, etc. 



CHAPTER I. 

DISEASES OF BONES, 

The diseases affecting bony tissues may broadly be divided into local 
and general. Local diseases like ostitis, periostitis, necrosis, fracture, 
etc., are somewhat rare, and are less important in cattle than such 
general diseases as rachitis and osseous cachexia. 

Eachitis is a disease of young animals, and occurs during the growing 
period. Osseous cachexia is a disease of adults. Nevertheless, there is 
a relationship between these two morbid conditions, for they frequently 
co-exist in one family. Moreover, brood mares and cows suffering from 
osseous cachexia give birth to foals and calves, which, if left with their 
mothers, almost inevitably become rachitic. 

The general characteristic common to both rachitis and osseous 
cachexia consisting in diminution in the normal proportion of mineral 
salts entering into the constitution of the bone, numerous theories have 
been advanced to explain this irregularity in nutrition. 

The theory of insufladency is one of the oldest. It presupposes that 
the young animals' food contains insufficient mineral salts necessary for 
building up the skeleton, hence rachitis ; or again, that the daily food 
of the adults does not afford sufficient mineral salts to compensate for 
the normal transformation which is continually going on within the 
organism, and for the direct losses which occur through the medium of 
the urine, milk, etc. 

This extremely simple theory api)ears perfectly logical, but unfortu- 
nately does not fit in with all the observed facts. In reality, rachitis 
attacks children whose supply of milk, from a chemical point of view, 
leaves nothing to be desired. The same is true of animals, particularly 
of young pigs. The so-called ''acid theory" has therefore been ad- 
vanced to explain the points left obscure by its predecessor. 

The acid theory. According to this theory, the food may contain 
more than sufficient mineral material without, however, preventing the 
development of rachitis or of osseous cachexia. 

In animals suffering from digestive disturbance the alimentary tract 
may become the seat of excessive fermentation or of changes in secretion. 
There is thus produced an excess of lactic acid which passes into the 

B 2 



4 DISEASES OF BONES. 

circulation and accumulates in the tissues, checking the processes which 
end in ossification or, in the case of adults, even leading to decalcification. 

It seems fairly well established that experimental administration of 
lactic acid to animals causes diminution in the quantity of calcium salts 
contained in the bones (Siedamgrotsky, Hofmeister). On the other hand 
however Arloing and Tri2)ier failed to produce rachitis experimentally. 

Bouchard revived this theory in a somewhat modified form. He con- 
siders that calcium salts are absorbed as carbonates and chlorides and 
phosphoric acid as phospho-glyceric acid. The reaction which these 
compounds undergo wdthin the organism ends in the formation of the 
phosphate of calcium necessary to ossification, but this '' phosphate of 
ossification " cannot be deposited if the organism contains an excess of 
lactic acid. 

Theory of inflammation. A third theory which until now has received 
very little support is that called the theory of inflammation. The general 
lesions Avhich characterise rachitis are regarded as resulting from primary 
attacks of ostitis and osteo-periostitis. The cause of these forms of 
inflammation is not suggested. 

To the above views may be added that more recently emitted by 
Dr. Chaumier, according to which rachitis is of an infectious nature. 
Unfortunately no proof of this has yet been adduced. 



GENERAL DISEASES* 
RACHITIS, 

Eachitis is a disease of youth, and is common both to the human 
species and to all domestic animals. It is characterised by irregularities in 
development and by imperfect consolidation of the bones. The boundary 
between rachitis and osseous cachexia is difficult to define and in fact 
at the present moment the two diseases can scarcely be defined with 
exactitude. Eachitis again is often complicated with softening of the 
bones, disease of the limbs, arrested development, etc., but it must not be 
forgotten that although the irregularities in ossification and development 
'of the skeleton are the symptoms most striking to the eye, they do not stand 
alone, and that from the point of view of development all the tissues, 
including the muscles, are more or less affected and that most of the 
physiological functions such as digestion and the secretion of urine are 
deranged. 

Etiology. One of the principal causes suggested is that of heredity, 
and so far as human beings are concerned, one seldom fails to discover 
the rachitic taint. Certainly the offspring of individuals marked by any 
debilitating disease like alcoholism, tuberculosis, syphilis, etc., are poorly 



RACHITIS. 5 

equipped for their future development. Their tissues lack the necessary 
qualities and, cceteris paribus, their physiological functions are performed 
less perfectly than are those of normal individuals. 

It is difficult to apply such information to domestic animals, because 
badly developed subjects are not used for reproduction and the import- 
ance assigned to heredit}' can therefore scarcely be sustained. The 
conditions of life, on the contrary, have an unquestionable influence, 
and if rachitis is so frequent in young animals living near towns, for 
example, it is undoubtedly due to that want of air, light and liberty, 
which first affects the mother's health and later that of her offspring. 

The same may be said of insufficient and improper food ; for in this 
connection quaUty is of even greater importance than quantity. Even 
free feeding is insufficient if the fodder does not contain the material 
necessary for sustaining and building up the developing frame, a point 
which readily explains the occurrence of rachitis when young animals 
receive a diet deficient in certain chemical constituents. 

This occurs in young lambs and pigs where the mothers are given too 
little variety or too small a quantity of food. 

In calves and foals rachitis is rare but occurs when the mothers are 
exhausted or cachectic or are debilitated by chronic wasting diseases like 
tuberculosis or osseous cachexia. The milk is then no longer of normal 
chemical constitution. 

One fact appears to dominate the whole subject of the causation of 
rachitis, viz., the failure to assimilate sufficient of the mineral salts 
required in building up the skeleton. This failure to assimilate may be 
caused by too meagre feeding, but even when the food is sufficiently rich, 
some digestive disturbance may reduce the amount absorbed below 
normal. This appears the only plausible explanation unless we admit Dr. 
Chaumier's theory that the disease is of an infectious character. 

Symptoms. The onset is absolutely insidious and the diagnosis of 
rachitis is never made until nutrition has long been abnormal. 

This disturbance of nutrition is revealed by irregularity and abnor- 
mality in appetite, by difficulty in rising and moving about, and by the 
animals lying down for long periods. The subjects are feeble, sluggish 
and badly developed. 

Next supervenes the second phase characterised by deformity of bones. 
This is of two kinds — deformity in the neighbourhood of joints (deformity 
or enlargement of the epiphyses) and deformity of the diaphyses. The 
former results from irregularity in ossification of the articular cartilages, 
The latter is followed by loss of rigidity in the bones of the limbs which, 
under the influence of the body weight and of muscular contraction, bend 
in different directions. 

The bones appear of increased thickness principally towards thg 



RACHITIS. 




r^^ 



M 



articulations. The latter are deformed, and on palpation are found to 
be surrounded by uneven and irregular growths. 

The front limbs are distorted. In young pigs, lambs, and less 
frequently in foals, calves and dogs, the jaws become deformed, and 
mastication is rendered difficult. 

The vertebral column may also be affected, and lordosis (bending 
downwards of the back) or skoliosis (lateral bending of the back) is some- 
what frequent. 

Cyphosis, or upward bending of the back, seldom occurs, and when 
seen, sometimes results from disease other than rachitis. 

General development is always in- 
terfered w^ith and the young creatures 
are generally dwarfed. 

The digestive apparatus is dis- 
ordered, the ajDpetite is irregular and 
sometimes depraved, wdiile indiges- 
tion, gastritis, and enteritis are not 
exceptional. Physiological and patho- 
logical research has shown that the 
quantity of phosphoric acid elimi- 
nated in tw^enty-four hours in a 
rachitic child is double the quan- 
tity passed by a healthy infant. 
The amount of urea in the urine 
(which is a criterion of nutrition, and 
usually varies in proportion to the 
amount of food ingested) is, on 
the contrary, diminished even when 
highly nitrogenous food is given, 
thus suggesting diminution in nu- 
trition. 
Lesions. The lesions are represented by abnormal and irregular 
thickening around the inter-articular cartilages. The cartilage is 
thickened, compressible, very spongy and without regular ossification. 
Diffused periostitis exists principally towards the extremities of the bone. 
Beneath the periosteum the surface of the bone appears rough and 
softened. On section the medullary canals are seen to be enlarged and 
filled with marrow of a gelatinous character. The Haversian canals are 
dilated, and the entire tissue appears very vascular. Chemical analysis 
proves that the mineral constituents of the bone, particularly the phos- 
phates, have diminished by one-half; the organic constituents on the 
other hand are increased in a similar ratio, but the ossein is abnormal. 
Ossification has, in a word, been incomplete. 



Fig. 1. — Eachitis in a young goat. 



RACHITIS. Y 

Diagnosis. Diagnosis presents no difficulty except in the early stages 
before deformity has occurred. 

Eachitis can scarcely be mistaken for any other condition except 
perhaps infectious rheumatism, but the rapid course of the disease in the 
latter case, the persistence of fever and the swelling of the joint cavities 
sufficiently differentiate the conditions provided care is exercised. 

Prognosis. From an economic point of view the prognosis is very 
grave for if the lesions are extensive there is nothing to be gained by 
keeping the animal. 

Treatment. Treatment differs very little, whether the animals are 
still being suckled or have been w^eaned. In the former case it is 
necessary to improve the quality and chemical constitution of the 
mother's milk by giving food, richer both in mineral salts and in 
nitrogenous material. 

Cooked grains, milk, and forage of good quality should be given freely. 
When the mothers are exhausted and anaemic it is better to feed the 
little animals artificially or to change them to a foster-mother. Those 
already weaned should be given good rich milk, eggs, boiled gruel, and 
drugs, such as the phospho-chlorate of lime, 1 to IJ drachms per day (for 
a calf) ; lacto-phosphate of lime, 1 to IJ drachms ; bi-phosphate of lime, 
1 drachm, or simply ordinary phosphate of lime. Oil containing 1 per 
cent, of dissolved phosphorus may be given in doses of 1 to 2J drachms, 
according to the size of the calves, but its use calls for much care, and it 
should only be given for alternate periods of a fortnight. The glycero- 
phosphates are not very active. Beef meal in doses of 6 drachms to 
1| ounces and chloride of ammonium in doses of 30 to 60 grains have 
also been used advantageously. The above drugs, but particularly the 
bi-phosphate of lime and chloride of ammonium, stimulate nutrition and 
diminish the quantity of phosphoric acid eliminated. 



OSSEOUS CACHEXIA. 

" Osseous cachexia " is a general disease which develops slowly and 
progressively, producing its most marked effects on the bony tissues. 
It has received a great many different names, such as osteoporosis, 
osteoclastia, osteomalacia, fragilitas ossium, enzootic ostitis, bone 
softening, etc., but none of these appears so appropriate as the term 
osseous cachexia, suggested by Cantiget. 

All the above-mentioned names are ajDplicable to some phase of the 
disease, but none to the disease in its complete development. Thus the 
name "osteoporosis," accepted by German authors, is quite applicable 
to the phase of rarefying ostitis seen at the commencement, but this 
condition occurs in other diseases. The expressions '* osteoclastia " and 



8 OSSEOUS CACHEXIA. 

'' fragilitas ossium " suggest the fragility of the bones and the common- 
ness of fracture. The term "osteomalacia" is warranted during the 
period of bone softening. The term ''gout," though in practice confusing, 
has been held to be justified by the frequent appearance of synovitis and 
arthritis; while that of "enzootic ostitis" indicates the appearance of 
the disease in all the stables in one district, without however pointing 
to its nature. It is possible that under certain circumstances the train 
of symptoms might be incomplete, and then the terms above indicated 
would be quite inappropriate. "Osseous cachexia," on the other hand, 
is very comprehensive, and appears to cover the entire development of 
the disease, for which reason it here receives preference. 

Law defines the disease as " a softening and fragility of the bones of 
adult animals, in connection with solution and removal of the earthy 
salts." He describes it as an enzootic disease of mature animals — mainly 
cows — in which the decalcifying process proceeds most actively in the 
walls of the Haversian canals and cancelli of the affected bones. In 
consequence of the removal of the earthy salts the bones become soft 
and more or less fragile. 

The disease has been observed in England, Scotland, United States, 
France, Belgium, and Jutland, and generally in districts with low- 
lying damp pastures. It attacks cows which are heavy milkers. 
Susceptibility appears to increase with advancing age. 

History. Having been described by Vegetius, the disease was again 
observed about 1650 in Norway where it was treated by the administra- 
tion of crushed bones. It is fairly frequent in some parts of Germany 
and Belgium. In France it was studied in 1825 by Eoux, and in 1846 
by Dupont, but Zundel in 1870 was the first who gave a good description 
of it, founded partly on the authority of German authors and partly on 
observations made by himself in the Valley of the Lower Ehine. Since 
that time it has successively been reported in the Yonne by Thierry, in 
the Nievre by Vernant, in the Aube by Collard and Henriot (1893), in 
the Indre by Cantiget, as well as in La Vendee by Tapon in 1893. In 
that and the succeeding year Moussu also saw numerous cases in the 
districts of Indre-et-Loire, Loire-et-Cher, Berry, Sologne, and in some 
parts of Beauce. 

Symptoms. The first symptoms are difficult to detect and interpret, 
especially at the commencement of an outbreak and in parts where the 
disease is rare they may lead to confusion and errors in diagnosis. On 
the other hand, in regions where the disease is common the practitioner 
will be able to form his diagnosis from the appearance of the first signs. 

To render clear the mode in which the symptoms develop we may 
divide the progress of the disease into four phases, though this grouping 
is somewhat arbitrary. 



OSSEOUS CACHEXIA. 9 

1. The initial phase is not well marked, and is announced by digestive 
disturbance and by wasting. The former of these symptoms may be 
referred to some other cause, but consists in irregularity, diminution 
and sometimes perversion of the appetite. These earlier signs are soon 
followed by loss of spirits, and some interference with movement, but 
the symptoms only become of importance or attain their full develop- 
ment when the animals remain lying for a long period in the stable. 

2. The second phase is characterised by more precise signs, which 
become almost pathognomonic. Difficulty in rising is added to the 




Fig. 2. — Horse suffering from osseous cachexia. 

already existing tendency to remain lying, and to the interference with 
movement. 

When lying down the patient no longer responds to the trifling 
stimulus, which a healthy animal needs to cause it to rise. It remains 
languid and apparently lazy, though in reality it experiences pain 
and difficulty on attempting to get up. The least muscular effort when 
lying down often causes it to moan, as do efforts to change its position 
or to walk. Even when standing still, it may appear to be in pain, 
and patients often assume a position similar to that of a hoi'se suffering 
from laminitis. 

At the end of this second phase, swellings appear, due to synovitis or 
arthritis of the extremities, synovitis of the sesamoid or navicular 
sheaths or to inter-phalangeal arthritis or arthritis of the fetlock joint. 
Weakness becomes marked, and the appetite is very irregular. 



10 OSSEOUS CACHEXIA. 

Secretion of milk diminishes or ceases and abortion is not un- 
common . 

3. The third phase is characterised by fractures, and it is this 
pecuKarity of the disease which has procured for it the names of fragi- 
Htas ossium, and osteoclastia. These fractures may affect any portion 
of the skeleton. Animals so suffering sometimes break a leg whilst 
trotting or the pelvis in simply jumping over a ditch; a collision with a 
fixed object like the jamb of the stable door, or a fall on the ground, 
may result in the fracture of one or several ribs. 

Such shocks would be of no importance to a healthy animal, but to 
one suffering from osseous cachexia, any violence, or even the slightest 



Fig. 3. — Pig suffering from osseous cachexia (fourth stage). 

muscular effort may be followed by fracture of the gravest character, 
involving even the vertebral column. In cow^s the pelvis, femur, and 
tibia are most frequently injured. 

In horses, particularly in riding horses, fractures are commonest in 
the region of the forearm, cannon bone, and anterior phalanges. So 
extremely fragile are the bones at this stage that the horse represented 
herewith broke twelve ribs at one time by simply falling on its side. It 
is interesting to note that such fractures are never accompanied by any 
extensive bleeding. They have little tendency to repair, no real callus 
formation occurs, and on post-mortem examination one often finds the 
ends unconnected by temporary callus, worn, and rounded by reciprocal 
friction. 

At this stage but under other circumstances, the animals show great 
reluctance to rise, remaining down for twelve to twenty-four hours 
without shifting their position. ♦ If forced to get up, they stand as 
though fixed in one position, the respiration and circulation become rapid, 
and they soon grow tired and fall, 



OSSEOUS CACHEXIA. 



11 



4. The fourth phase, or period of osteomalacia, i.e. softening of the 
bones, is also the last. It is rarel}' seen in large animals like horses and 
oxen, because accidents so often accompan}^ the preceding stages and 
necessitate slaiigliter ; but it is common in goats and pigs. 

In tliis phase the bones become elastic, soft and depressible, j^ielding 
to the pressure of the operator's fingers. 

The flat bones are particular^ liable to this change, which is common 
to domesticated animals. The bones of the 
head are the first to suffer ; later those of the 
pelvis. The lower jaw becomes swollen, par- 
ticularly about the centre of the branches 
which may attain three, four, or five times, 
their normal thickness. 

The depression in the submaxillary space 
disappears. The upper jaw undergoes similar 
changes, becoming deformed and thickened 
until the cavities of the sinuses and the 
hollow appearance of the palate are lost, while 
the face is so changed that it cannot be 
recognised as that of a horse, goat, etc. 

The molar teeth are almost buried, their 
tables alone being visible at the bottom of a 
depression, the edges of which rise above the 
neighbouring parts (pig). 

Mastication is clearly impossible, the jaws 
appear paralysed, the muscles powerless, and 
only swallowing is possible, a fact which 
explains why life is only prolonged to this stage 
in animals which can be fed with a spoon or 
bottle (pigs and goats). The bones of the 
cranium, although greatly changed in texture, are always less deformed 
than those of the face. 

The changes are such that it is often easy with a mere post-mortem 
knife to cut the head completely in two. Osseous tissue, properly 
so-called, has disap^Deared. 

All the constituent tissues, with the exception of the skin and muscles, 
i.e., the bone, periosteum and aponeuroses, have the appearance and 
consistence on section of the fibro-lardaceous tissue seen in chronic 
inflammation. 

The following is a condensed description of the disease as given by 
Law : — 

Symptoms. Poor condition or even emaciation, with very visible 
projection of the bones. The coat is rough, skin tense, inelastic and 




Fig. 4. — Defoniiitj of the 
face in the horse shown 
m FiR. 2. 



12 OSSEOUS CACHEXIA. 

hidebound, appetite variable, sometimes impaired, and nearly always 
perverted (or depraved) so that the patient will lick the manger con- 
tinually or pick up and chew all sorts of objects: bones, leather, 
clothing, wood or iron, stones, etc. The amount of food consumed 
may, however, be up to the normal. The most marked feature is the 
difficulty and stiffness of locomotion. . . . Temperature and yield 
of milk may remain normal. 

'' Later, appetite and milk secretion fail, temperature rises a degree 
or two, the animal refuses to rise, remaining down twelve to twenty-four 
hours at a time, and . . . when rising . . . remaining on the 
knees for a time, moaning and indisposed to exert itself further. At 
this stage many cases begin to improve and may get well in five or six 
weeks. Some will remain down for several weeks and finally get up 




Fig. 5. — Head of a pig suffering from osseous cachexia. 

and recover. With constant decubitus, however, the animal falls off 
greatly, becoming emaciated and weak, the appetite may fail altogether, 
and the patient is worn out by the persistent fever, nervous exhaustion 
and poisoning from the numerous bed-sores . . . which are common 
over the bony prominences. It is in these last conditions, above all, 
that fractures and distortions of the pelvic bones, and less frequently of 
the bones of the legs occur." 

" The disease may advance for two or three months, and in case of 
pelvic fractures and distortions, there may be permanent lameness, and 
dangerous obstruction to parturition, even though the bones should 
acquire their normal hardness through the deposition of lime salts." 

In horses, the different phases of the disease develop precisely as in 
bovines. The apparent differences between affected horses and cattle 
result in reality from differences in their capacity for continuing work. 
In the first phase, horses are incapable of work, their movements being 



OSSEOUS CACHEXIA. 



18 



badly co-ordinated. They are inclined to stumble, and appear as though 
suffering from strain of the lumbar muscles. 

In the second phase pain referable to the bones sets in. Lameness 
develops without visible lesions and is rapidly followed by synovitis and 
arthritis in the lower portions of the limbs, and by wasting and anaemia. 

The animals seem unable to move rapidly, or if forced to do so may 
sustain fractures even at a trot : the limb bones sometimes break or 
ligamentous insertions in the neighbourhood of joints are torn away, 
resulting in sudden falls on the ground and fracture of ribs or even of 
the vertebral column. This corresponds to the 
third phase, osteoclastia, in oxen. 

From then onwards, horses become useless 
and, if not destroyed, may, after a few weeks 
or months, develop the condition known as 
osteomalacia, in which the flat bones become 
softened, the head, the branches of the lower 
jaw and the face become deformed, while 
mastication and other functions are impeded. 

Germain gives the above symptoms as 
characteristic of the mode of development of 
the disease in French and Algerian horses 
imported into Tonquin, and his description, 
written several years ago, is fully confirmed by 
more recent observations. Since Tonquin was 
taken over by the French, however, improved 
methods of culture have resulted in the produc- 
tion of better cereals and forage ; the fodder 
plants have been vastly improved, to the great 
benefit of imported animals. 

In the goat, the disease shows some slight 
peculiarities. Thus, in the second phase, during 
which goats and sheep suffer so markedly from 
lameness and pain in ^ the bones, goats often 
walk on the knees. The disease, however, is uncommon in these animals. 
The phase of osteoclastia is also less marked and fractures are rare, 
because the animals weigh less and also because they are less exposed 
to falls and violent shocks. The bones, nevertheless, are extremely 
fragile and fractures may be produced at will. 

Osteomalacia, on the other hand, is always well marked. 

Eegarding the development of the disease in pigs, we may repeat what 
has just been said respecting the goat. Walking on the knees is often 
one of the first signs, fractures are somewhat rare, and the period 
of softening and deformity is always very noticeable. 




Fig. 6. — Osseous cachexia. 
This condition developed 
in two months, the last 
month of gestation and 
the first of lactation. 



14 



OSSEOUS CACHEXIA. 



Course. The development of the disease is slow, lasting from one to 
three months as a rule, and is little influenced by hygienic conditions. 
Good milking cows, however, seem to be most frequently attacked, 
probably because of the great losses of nutritive material which occur 
through the milk. The calves borne by such animals are often rachitic. 
Oxen are less commonly attacked. Horses rarely suffer from the disease 
in France, but frequently in Tonquin. Pigs reared on very poor soil 
seldom escape attack. 

If treated from the beginning, or even before the second phase has 
become well developed, the disease may be cured, but after this 

period, little improvement need be 
expected. 

Causation. The problem of why 
osseous cachexia occurs has natu- 
rally given rise to numerous 
explanations, some plainly inad- 
missible, others, however, of greater 
or less plausibility. 

The fact which, from the earliest 
times, appears to have attracted 
most attention is the relation 
defective nourishment bears to 
development of the disease. In 
Norway, as early as the year 1650, 
the plant known as sterregraes 
(which renders animals dull and 
heavy) was thought to be the cause 
of the disease ; two centuries later, 
in 1846, the Antlieiicitm ossifragum 
was similarly regarded. Zundel, 
in 1870, claimed that the Germans 
first referred the development of 
the disease to chemically incomplete forms of nourishment. This opinion 
seems fully confirmed by the remarkable observations of Germain on 
European horses imported into Cochin- China, and it is finally placed 
beyond question by the work of Cantiget. Basing his researches on 
analysis of the soil, he proved that osseous cachexia only occurs in cattle 
depastured on land which is too poor in phosphoric acid and calcium 
phosphate, and that it can be banished by enriching the soil with suitable 
manures up to a point when the proportion of phosphoric acid becomes 
normal. In good land, suitable for raising cattle, the proportion of phos- 
phoric acid, according to the best exponents of agricultural chemistry, 
should not fall below 4,000 kilograms to the hectare. Cantiget and 




Fig. 7. — Osseous cachexia 
the maxillge. 



softenmg of 



OSSEOUS CACHEXIA. 15 

Brissonet have shown that where the soil contains less than 1,500 kilo- 
grams to the hectare, osseous cachexia is almost permanently present. 
As soon, however, as this proportion is raised above 2,000 kilograms by 
suitable culture, the losses diminish, and the cachexia finally disappears. 

This view was greatly strengthened by fodder analyses, which showed 
that in all cases where the soil is poor in calcium phosphate, the forage 
is poor in phosphoric acid, and vice versa. The food is too poor in 
mineral salts, firstly for normal development ; and secondly for the 
proper nutrition of the skeleton. 

Germain is of a similar opinion with regard to the occurrence of 
osseous cachexia in horses in Cochin- China, where the soil is very poor 
in lime. The fodder and cereals are poor in mineral salts, and even 
when given in large quantities do not furnish proper (chemical) nutri- 
tion. Clear proof of the correctness of this view is afforded by the fact 
that feeding with forage and cereals obtained from France or Algeria 
prevents the disease appearing, or diminishes and finally removes the 
previously existing symptoms. Furthermore, Germain shows that 
Europeans, living solely on the products of the country, to some extent 
suffer like the horses. 

This theory though based on sufficiently solid foundations to carry 
conviction, has been questioned, and it may be desirable to record briefly 
the criticisms advanced against it. 

One of the most important is as follows : — 

As osseous cachexia of oxen occurs in certain well-defined districts in 
France, and seems due to the feeding, why does it not attack horses in 
the same regions in an enzootic form ? The answer appears to be that 
horses receive a greater amount of rich food, particularly of cereals, 
which contain much larger amounts of mineral salts, including phos- 
phates, than does ordinary forage. 

The most serious objection was made by Tapon, who states that in 
1893 he saw osseous cachexia in oxen on farms in La Vendee where 
superphosphate had been used for years, whilst the disease did not exist 
on other farms where such chemical manures were not employed. 
Before attaching much weight to this objection, however, it would be 
necessary to know the richness in phosphoric acid of the soil on the 
respective farms, for it is possible that, in consequence of natural condi- 
tions and in spite of the use of certain mineral manures, the richness of 
the soil on the first-mentioned farms, though manured with superphos- 
phates, w^as still below that of the others which had received no artificial, 
manure. 

The system of culture is also of importance, for at the present day, 
even wdth the use of artificial manures, cropping would raj^idly im- 
poverish soils which were not suitably and sufficiently enriched. 



16 OSSEOUS CACHEXIA. 

Abundance or apparent richness of food signifies nothing if quality is 
lacking. 

It may also be asked : if the question of nourishment is of such prime 
importance why are animals of European origin in Cochin- China 
affected, whilst the indigenous races prove immune? The answer 
would appear to be that, in addition to the defective quality of food, 
other factors, such as adajDtation to environment and relative digestive 
powder, play a considerable part in the production of the disease. 

Favouring causes. Whilst conceding that the disease is due to one 
determining cause, viz. the food, it is unquestionable that other causes 
may favour its appearance. Abundant milking is one, so that the 
disease most frequently appears six to eight weeks after calving. Gesta- 
tion may also determine an attack. The disease is rarer in oxen than in 
milch cows. Starvation and bad hygienic conditions also have a certain 
influence ; it is well known that during dry years, particularly when 
fodder is scarce, osseous cachexia makes the greatest ravages. Law 
states that the disease has been attributed to excess of organic matter in 
the soil, to succulent watery foods, as rank watery grasses, potatoes, 
turnips and other roots deficient in nutritious solids. Some agent — 
microbe or toxin — swallowed with the food has been suspected but not 
yet isolated. 

Other explanations have been advanced but up to the present time 
they scarcely deserve to be regarded even as hypotheses. ThusAnacker 
in 1865 declared that the disease commenced as muscular rheumatism, 
was succeeded by destructive or atrophic ostitis, and ended as osteo- 
porosis. So far as the order of the osseous lesions is concerned, this 
view is quite correct, but the ossific changes are consequences and not 
causes. 

The idea that the disease was due to an infectious agent has been 
advocated by Leclainche, without, however, having been proved. 
Petrone is the only person who has hitherto suggested that osteo- 
malacia in man is due to infection with a nitric ferment {Micrococcus 
nitrificans). According to him, pure cultures of this organism injected 
into dogs, produce osteomalacia. These statements, however, require 
confirmation. 

Lesions. The chief lesions are to be found in the bones. They 
consist in rarefaction of the compact tissue, increase in size of the 
medullary cavity and Haversian canals, and enlargement of the areolae 
of the spongy tissue. The bone marrow loses its fatty constituents, 
appears red and gelatinous, and contains a greatly exaggerated number 
of blood-vessels. When heated, the bones do not yield oil as in healthy 
subjects, and when dry, they seem abnormally porous. In the osteo- 
clastic phase, the bones become very friable and even the shafts assume 



OSSEOUS CACHEXIA. 



17 



a spongy appearance. They diminish in density. These changes 
correspond to the stages of eccentric rarefying ostitis and osteoporosis 
of German authors. 

The flat bones often show well-marked periostitis, but the great 
thickening sometimes seen in certain of the bones of the head appears 
to be the result of a special osteo-periostitis. It is quite certain that 
the disease is due to something more than a mere want of mineral 
constituents in the bone, and poverty in this respect certainly does 
not explain the hypertrophic changes. The nutrition of the bones as 
a whole is disturbed, resulting in alterations both in the ossein and 




Fig. 8. — Transverse section through the middle region of the face in a pig 
suffering; from osseous cachexia. 



in the mineral salts, the whole process being accompanied by symptoms 
of osteo-periostitis. 

The fractures which occur so frequently during the osteoclastic phase 
have well-marked peculiarities. The extravasation of blood is trifling, 
and no callus forms, even when the ends of the bones are immobilised 
by external aid ; if the ends are left free, they soon become worn and 
polished by rubbing against one another. 

r [ In the neighbourhood of the articulations and ligamentous insertions 
the periosteum soon undergoes change, and it is not uncommon to find 
sub-periosteal and intra- osseous extravasations of blood, 

Germain has also noted in horses the disappearance of the interver- 
tebral and articular cartilages, and the frequent occurrence of anchylosis, 
true or false. 

D.C. 



18 OSSEOUS CACHEXIA. 

In the final stages, the hones may he cut with a knife, and a time 
arrives when bon}^ tissue seems completely to have disappeared ; thus, as 
shown in Fig. 8 herewith, it was possible to cut the entire head of a pig 
into thin slices without the slightest difficulty. All parts of the head had 
been affected by the softening change. 

From the chemical p)oint of view, the diminution in mineral salts and 
in phosphate of calcium has long been recognised, but the degree of this 
change varies according to the phase. In human beings the proportions 
have been estimated as follow^s : Normal bone, 50 to 80 per cent, of 
phosphate of calcium ; bone in persons suffering from osteomalacia, 5 
to 20 2)er cent, of phosphate of calcium. The changes in the ossein 
have not been carefully studied. We only know that histologically the 
ossein becomes fibrillar, and that chemically it no longer retains its 
normal comj^osition. 

The diagnosis is difficult, particularly on the first occasion of seeing 
the disease, and especially if this is of an enzootic character. The 
practitioner may also have some hesitation in diagnosing isolated cases 
in regions where the disease seldom occurs. 

Otherwise, diagnosis is usually easy, as soon as lameness or synovitis, 
or arthritis of the lower regions of the limbs appears. Only in isolated 
cases are the lesions likely to be mistaken for accidental injuries, and it 
is also fairly easy to differentiate them from the localised lesions of 
rheumatism. The latter disease seems more frequently to attack the 
uj)per joints of the limbs, and is often accompanied by intense fever and 
cardiac disturbance. 

Prognosis. In a general sense the disease is very grave, because it 
appears as an enzootic, and, in dry years and those during which there 
is a scarcity of forage, inflicts enormous losses on the breeders of certain 
countries. When advice is sought towards the end of the second phase 
of the disease the prognosis is therefore very grave. Under such cir- 
cumstances it is often better to slaughter rather than to treat, provided 
that the affected animals, like cows, pigs, or goats are still of some value. 

The prognosis is much more ho23eful if treatment is attempted at an 
early stage, when improved diet and the use of suitable drugs sometimes 
lead to recovery. 

Treatment. We know that in the Middle Ages this disease was often 
treated by the administration of crushed bones, and even at the present 
day ground bones are frequently recommended. Treatment must be 
subordinated to proper feeding, no system of medication being of any 
value whatever unless the food is suitable. 

Germain states that imported horses in Cochin-China recover if 
simply returned to their former diet, i.e. to cereals and forage obtained 
from France or Algeria. Cantiget shows that such improvements in 



OSSEOUS CACHEXIA. 19 

cultivation as the free distribution of superphosphate manures on 
impoverished soils modify the chemical composition of the forage, 
and render it capable of building up and sustaining the organism and 
bony tissues ; treatment should therefore be essentially prophylactic 
in character. 

Animals suffering from osseous cachexia should be fed on cereals and 
forage obtained from rich districts ^Yhere the disease has never occurred; 
but, as in times of scarcity questions of expense almost always receive 
first consideration, it may be necessary to substitute bran for such 
products, or give oats, maize, beans, rice, and oil or cotton cake, etc., 
all of which can be obtained commercially, and are of sufficient 
nutritive richness. It is often advantageous to give such food cooked 
and slightly salted. 

Commercial ground bones and calcium phosphate (bi- or tri- basic), in 
doses of 1 ounce per day for oxen and IJ to 2 drachms for pigs or goats, 
have given excellent results in the hands of most practitioners. Some 
recommend the addition of iron salts or bitter tonics like gentian or 
nux vomica in doses of 2J drachms per day for a full-grown ox. 

Law declares that the treatment should be varied " with the pre- 
dominance of the causes, essential or accessory. . . . Green clover, 
alfalfa, and other leguminous products, ground oats, beans, peas, 
linseed or rape cake . . . and vetches ma}- be especially recom- 
mended. . . . The free access to common salt and a liberal supply 
of bone meal are helpful. . . . Apomorphia is especially valuable in 
correcting the perverted appetite and stimulating digestion. A change 
of pasture is alwa^^s advisable. In all cases where possible the water 
should be changed as well as the food. Attention to the housing, 
grooming, and general care of the animals should not be neglected. 
Finally, every drain upon the system should be lessened or stoi^ped. 
The milk may be dried up, and the animal should not be bred." 

Meat meal also renders good service, but the use of cod liver oil, 
suggested by Zundel, is too expensive, and phosphorised oil is too 
dangerous to be adopted in ordinary treatment. 

Local treatment for synovitis and arthritis has been recommended. 
It is ineffective unless accompanied by good feeding and internal 
medication. On the other hand, the lesions often diminish rapidly or 
totally disappear under the influence of general medication alone. 



c2 



20 FRACTURES. 

LOCAL AFFECTIONS, 
FRACTURES. 

Although oxen, sheep, goats, and pigs are much less subject to 
fractures than the horse and dog, nevertheless, they do suffer from 
such accidents. Eepair is perfectly possible, but the cases are often not 
worth treating, unless the subjects are young or of considerable value. 
On the other hand, in fat and heavy subjects, it is difficult to fix the 
parts in position. Slinging produces bad results, and generally should 
not be encouraged. 

Apart from fractures accompanying general chronic diseases, like 
rachitis and osseous cachexia, the vertebrae, the pelvis, the ribs, or any 
of the limb bones, may be fractured in consequence of accident. 

Such fractures may be either complete or incomplete (fissures), 
simple or compound. 

The general signs which indicate fracture are alwaj^s the same, viz., 
loss of function, local pain, abnormal mobility, crei^itation, due to rubbing 
together of the ends of the bones, and deformity of the part. Diagnosis 
is generally easy ; prognosis on the other hand is very variable. 

The vertebral column may be accidentally fractured in the region of 
the neck in consequence of the animal falling on its head ; in the dorso- 
lumbar region, from falling into ditches or ravines, or, in the case of 
bulls fighting, from violent muscular efforts. Fractures of the first 
kind are immediately fatal ; those of the second result in paraplegia 
of the hind limbs, and necessitate immediate slaughter. 

Fractures of the pelvis comprise : — 

1. Fractures of the angle of the haunch, resulting from external 
violence and characterised by sinking of the external angle of the 
ilium, deformity of the hip, and lameness without specially marked 
characters. This fracture is rarely complicated. The symjptoms of 
lameness diminish with rest, but deformity continues. 

2. Fractures of the floor of the pelvis, usually extending from the 
anterior margin of the pubis to the foramen ovale and from the 
posterior margin of the foramen ovale to the end of the symphysis. 
They result from obstetrical manipulation, as in forcibly removing a 
foetus which is too large, or a monstrosity. As a rule, the animals 
cannot rise, or if they succeed in doing so, are incapable of moving. 
Diagnosis is made by exploration through the rectum. Such fractures 
always necessitate slaughter. 

Fractures of the neck of the ilium and of the base of the cotyloid 
cavity, even in cases of dislocation, are rare despite what has been 
said to the contrary. 



FEACTURES. ^1 

In the fore limb, fractures of the scapula and humerus are usually 
of traumatic origin, are seldom accompanied by marked displacement, 
and are capable of uniting if a long rest at grass is allowed. Pitch 
bandages should be applied to the surface, covering all the surrounding 
regions, viz. the withers, uj^per portion of the forearm, girth and chest, 
to assist in immobilising the region of fracture, and to promote union. 

Fractures of the forearm are more difficult to treat, because the 
bandage applied must extend as far as the hoof. In this case displace- 
ment often occurs. It is therefore necessary, firstly, to reduce the 
fracture, and bring the ends in perfect contact, for which purpose it 
may be requisite to cast the animal, and give an anaesthetic ; and, 
secondly, to apply a pitch plaster in the form of a shallow gutter, leaving 
the inner surface of the limb uncovered along a line about two inches 
wide following the course of the veins of the forearm. 

Fractures of the metacarpus and metatarsus usually heal well in all 
animals of moderate weight, such as heifers, steers, goats or sheej), 
provided a simple plaster bandage, covering the entire limb or prefer- 
ably with an opening in the position above indicated, is applied and 
continued downwards as far as the claws. 

In sheep and goats it is sometimes even sufficient to use a splint 
formed of straw-boards, and in the case of oxen, of wood, applied over a 
cotton-wool padding and retained in position by straps, or in the case 
of the heavier animals by dextrine or pitch bandages. 

In the hind limb, fractures of the femur are more serious, because the 
apparatus that can be used to secure immobility is seldom or never 
effective; excepting in young animals, it is therefore usually better to 
slaughter. 

Fractures of the tibia are treated like those of the forearm when it 
appears desirable to keep the animals alive. 

Plaster bandages can very easily be prepared by saturating tarlatan 
in a mixture of equal parts of thoroughly dry plaster and water. Six to 
ten thicknesses of tarlatan, arranged alternately longitudinally and 
transversely, are sufficient. When adjusted they can be kept in position 
until the plaster has hardened by means of dry bandages applied from 
below upwards, which can be removed after a lapse of half an hour to 
an hour. 

FRACTURES OF THE HORNS. 

Anatomy of the horns. The horns form organs of defence, and 
project on either side of the frontal bone at the poll. Each consists 
firstly of a bony basis generally known as the horn core ; secondly, of a 
horn-secreting membrane ; thirdly, of a horny sheath, the horn properly 
so called. 



22 FRACTURES, 

(1.) The horn core projecting from the frontal bone does not 
develop until after birth. About the third month a little prominence 
ajDpears under the skin, which, as it develops, assumes a conical shaj)e, 
and may be seen to be covered with a horny substance. In proportion 
as the horn core grows, there develops within it a cavity which may 
either be of a simple character or divided by a longitudinal partition. 
This communicates with the frontal sinus, a fact which explains the 
collection of pus in the sinuses as a result of injuries to the horns. 
The sinus of the horn core does not exist in young animals, and is not 
completely developed before the third or fourth year of life. 

(2.) The horn-secreting membrane is formed by the skin, which under- 
goes special develo23ment around the base of the horn and comes to 




Fig. 9. — C, horn ; P, modified skin forming the keratogenous membrane ; 
O, horn core, exhibiting a double sinus. 

resemble that of the coronary band, from which the hoof or claw is 
secreted. The band is about one-fifth of an inch in breadth. The 
papillae of the dermis are specially developed at this point, and the 
epithelium which they secrete eventually forms the horn. 

The internal surface of the growing horn is adherent to the horn core 
through the medium of another tissue formed by a specially differentiated 
periosteum which is continuous with the periosteum covering the frontal 
bone. It is not a true periosteum, but a vascular tissue formed of papillary 
layers analogous to those of the podophyllous tissue of the ox's claw or 
horse's hoof. 

This keratogenous membrane receives a rich vascular supply from 
the arterial circle formed at the base of the horn core by a division 
of the external carotid, the blood conveyed by which is freely distri- 
buted to the enlarged papillae. The great vascularity of these parts 



FEACTURES. 23 

explains why lesions of the horns are often followed by such profuse 
bleeding. 

(3.) The horn secreted by the papillae of the horn band (which is 
analogous to that of the coronary band of the horse) forms a cone 
varying in its curve in various breeds. Its base is hollow, and 
contains little depressions holding the papillae from which the horn is 
secreted. From its base up to the end of the horn core the walls pro- 
gressively increase in thickness. From this point it is solid ; in a 
fully-grown horn the bone does not extend more than one-half or 
two-thirds of the entire length. 

In the adult, the development of the horns varies with different 
breeds and is affected by sex. In the bull the horns are short, but in 
the cow and ox long. Short and fine in animals of improved breed like 
the Durham, they are long and thick in breeds of working oxen. 

Injuries affecting the horns are of three classes, determined by the 
part affected. 

1. Detachment of the horn or sheath. 

2. Laceration : — 

(a) Of the horny sheath alone. 

(b) Of the horny sheath and of the horn core. 

(c) Of the horn core alone, the horny sheath remaining intact. 

3. Fractures : — 

(a) Of the terminal half of the horn. 
(h) Of the lower half, 
(c) Of the base. 

DETACHMENT OF THE HORNS. 

When the yoke is badly fitted or padded, it is liable to cause a 
continual strain or a succession of shocks producing chronic inflam- 
mation of the keratogenous membrane. Should the end of the horn 
then be struck heavily, it is quite possible that the horn will either 
partially or wholly be detached. In this case it falls away without there 
necessarily being any important lesion of the horn core. 

Such accidents are not infrequently caused by the driver striking the 
ox on the horn with the yoke in order to keep it quiet while it is being 
harnessed. 

The prognosis of this condition is not grave, except for the fact 
that working animals cannot be used until the horn is completely 
regrown. 

The treatment simply consists in thoroughly cleansing and disin- 
fecting the horn core and then applying a protective dressing. The 
bony basis is surrounded with a mass of tow saturated with an antiseptic 



24 FISSURING OF THE HORNS. 

solution, like 2 per cent, creolin or carbolic acid solution, which is kept 
in position by a spiral bandage passed around the horn, and secured in 
a figure of 8 on the opposite horn. Instead of applying such a dressing, 
some practitioners content themselves with using an antiseptic ointment 
or even a simple dressing of tar. 

FISSURING OF, THE HORNS. 

Causation. In a general sense fissures may result from any violence 
affecting the centre portion of the horns, such as blows with the yoke 
or accidental bruises inflicted by the animals themselves in fighting 
with their neighbours. 

Symptoms. Whether the fissure is confined to the horny covering 
itself or whether it extends to both the portions constituting the horn, 
that is, the horny covering and the horn core, two very noticeable 
symptoms are always present : 1. A straight fissure resembling a sand 
crack, and ap23earing usually on the convexity of the horn, and, 2. A 
very trifling hsemorrhage, which does not appear until some hours or 
even a day after the accident. 

Diagnosis. If the lesion only affects the horn core, diagnosis is 
always difficult, for one can hardly perceive any sensitiveness of the horn 
near the fissure. 

Prognosis. Provided that the horn core is not injured, the prognosis 
is favourable ; but in the contrary case, it should be reserved ; for 
haemorrhage extending to the interior of the frontal sinus not infrequently 
causes supj^uration in that cavity. 

Treatment. Attemiots should first be made to check haemorrhage by 
applying masses of tow saturated with cold water and frequently wetted 
with slightly antiseptic solutions, such as 2 per cent, creolin or 
carbolic acid. If haemorrhage persists in spite of this simple treatment, 
astringents may be employed, which, by causing the formation of a clot, 
mechanically arrest further extravasation of blood. These astringents 
vary considerably in value, and we should particularly warn practi- 
tioners against perchloride of iron, which causes necrosis of the 
tissues, and later, formation of pus. A 5 per cent, solution of gelatine 
is haemostatic and excellent for the purpose named, as also is hydroxyl 
solution. When once haemorrhage is arrested, the keratogenous mem- 
brane rapidly heals in consequence of its vascularity, and soon secretes 
fresh horn. 



FRACTURES OF THE HORNS. 



25 



FRACTURES OF THE HORNS. 

Etiology. Fractures of the horns, hke fissures, are produced by 
violence, but of a more marked character. They are termed complete 
or incomplete, according as the entire thickness of the horn or only a 
portion of that thickness is involved. 

The fracture may affect either the terminal half or the basilar half ; 
or, again, it may have its seat in the frontal bone below the origin of the 
horn core, in which case a flake of bone will be detached. Such fractures 
assume varying forms, and may either be deeply excavated, oblique, 
smooth, regular or dentated. 

Symptoms. The symptoms are extremely simple. They consist 
mainly in the mobility of the frac- 
tured end, and such phenomena 
as sensitiveness, hsemorrhage, etc. 
When the fracture extends to the 
frontal bone, crepitation may also 
be noted. 

Prognosis. The prognosis is not 
grave unless the fracture extends 
to the basilar half of the horn or 
affects the frontal bone. 

Treatment. (1.) If the fracture 
is confined to the horn core, it is 
only necessary to bring the frag- 
ments into regular apposition, after 
having removed the broken end of 
the horn itself. 

(2.) In treating a fracture affect- 
ing the middle portion of the horn or in treating animals destined for the 
butcher, the best method is to make a simple wound by dividing the 
parts with a saw below the fracture. This is a painful operation, neces- 
sitating anaesthesia, and requiring the animal to be cast or firmly fixed to 
a post or placed in a trevis. To diminish the painful stage of the opera- 
tion, it was formerly recommended to make a circular incision extending 
through the entire thickness of the horn proper, and then to remove 
with a fine, very sharp saw the portion of the horn core. This, however, 
is scarcely practicable, and it is much better to make a direct section. 
HpBmorrhage is checked with compresses, moistened with cold water, 
after which a dressing known as the " Maltese cross dressing " (Fig. 10) 
is applied according to general principles. 

The surface of the section, after washing with an antiseptic solution, 
is powdered with iodoform or a mixture of iodoform and boric acid. 




Fig. 10.- 



-Dressing for fracture of 
the horn. 



26 



FRACTURES OF THE HORNS. 



covered with a mass of tow or cotton wool, saturated with liquid anti- 
septic, and then surrounded with a flat pad of wadding, which extends 
completely around the horn as far as its base. A second pad of larger 
size, intended to protect the wound against external violence, is arranged 
around the free extremity of the horn. This is kept in position by two 
small cross bandages. Another bandage, the loop of which is fixed to 
the base of the opposite horn, is then applied in spiral turns, completely 
enveloping the former pads and extending from the base to the point. 
Arriving at the free end, the operator reverses the bandage, draws it 
tight, and continues down to the base of the horn, fixing it by figure of. 8 
turns passed around the base of both horns. 

(3.) In dealing with fractures of the lower third of the horn in working 
oxen, it is necessary to seek consolidation of the horn by callus formation, 

so that the animals may again 
become useful in the yoke. 
Very great difiiculty accom- 
panies attempts to immobilise 
the horn in such cases, since 
the least shock to the extremity 
of the horn destroys the union, 
on account of the length of the 
lever represented by the horn 
itself. 

The first method of treatment 
consists, after the wound has 
been carefully disinfected, in 
fixing the ends in place by 
tightly applied pads, surrounded 
These are supported by several 




Fig. 11. — Splint for fractured horn. 



by splints, curved to fit to the horn, 
turns of a spiral bandage. 

Were one certain of the cleanliness of the wound and of its perfectly 
aseptic condition, it would be better at once to have recourse to a fixed 
bandage, strengthened by j^laster or silicate of soda. 

These bandages are applied longitudinally and should extend a con- 
siderable distance on either side of the fractures. If the horn is long and 
thick, it is best to use a fixed dressing of this kind secured by bandages 
in the form of a Maltese cross. 

All these methods, however, are more or less inconvenient, and the 
most practical procedure often consists in removing the horn. Treatment 
should only be attempted when the owner specially requests it in order to 
render the animal useful for working or show purposes. 

Moreover, however strong the dressing, accidents are frequent, for 
accidental shocks to the fractured horn interfere with the co-aptation of 



FRACTQRES OF THE HORNS. 



27 



parts, and diminish the chance of perfect] union. To avoid these draw- 
backs, the apparatus shown in Fig. 11 has been invented. 

This apparatus consists of a spKnt, the middle of which iits the back of 
the animal's poll, the sides being gouged out to receive the lower half of 
the horn and notched, to enable the fractured horn to be well supported 
by bandages. 

(4.) Fractures of the base of the horn are more serious, because a 
fragment of the frontal bone is usually torn away with the horn core. 
As a rule, the fracture is 
subcutaneous or without ex- 
ternal wound. The horn is 
displaced, and swings loosely. 
On examination, a charac- 
teristic crepitation sound is 
easily detected. In such frac- 
tures haemorrhage is subcu- 
taneous and often extends to 
the frontal sinus, in conse- 
quence of which it is not 
uncommon for pus to form 
in the sinus as a complica- 
tion. 

Treatment includes reduc- 
tion of the fracture, and the 
application of a fixed plaster 
or silicate bandage cover- 
ing the fron to -occipital and 
superior auricular regions. 

When a skin wound exists, it is better to remove the horn and bony 
fragment, and to aj^ply an antiseptic dressing in order to prevent infection 
of the frontal sinus. 




Fig. 12. — Dressing for fracture of the base 
of the horn. 



EXOSTOSES. 

SPAVIN IN THE OX. 

Exostoses are somewhat uncommon in the bovine species, and when 
they occur are rarely of great clinical interest. Nevertheless, in cows 
and old working oxen one sometimes sees metatarsal spavin. Its 
gravity, however, appears to be very much less than in the horse, on 
account of its position. Very commonly there is only trifling lameness. 

Treatment by application of biniodide of mercury ointment or the 
actual cautery gives good results. The principal precaution required is 
to prevent the animals licking the parts. 



28 



RING-BONE. 



RING-BONE. 

Eing-bones only occur in working oxen, and particularly in aged 
animals used in hilly regions. They result almost exclusively from 
wounds, ligamentous and tendinous strains, and articular injuries. 

They are preceded (as can usually be proved by dissection of limbs) by 




Fig. 13. — Tibia. Lesions due to open fracture and displacement. Irregular 
callus formation and seanestrum. 



fibrous or fibro -cartilaginous induration in or about the coronet or one 
of the phalanges. These thickenings increase the diameter of the 
pastern in all directions. Eing-bones are seldom very large ; but as they 



SUPPURATING OSTITIS. 



29 



partially or entirely surround the insertions of the lateral ligaments, 
inter-phalangeal articulations or insertions of the digital extensors, they 
are painful, and produce lameness of varying intensity. 

Diagnosis is easy, partly because the tension of the skin and the 
fibrous thickening render palpation painful. 

Prognosis is grave, because the effect of ring-bone is sometimes to 
render working animals useless. 

Treatment. To relieve the diseased claw of pressure due to its bearing 
on the ground, the shoe should be removed and the claw freely pared. 





Fig. 14. — Sarcoma of the periosteum 
beneath the scapula. 



Fig. 15.— Sarcoma of the periosteum 
covering the upper end of the tibia. 



If necessary, the healthy claw of the same foot may be raised by placing 
a piece of thick leather between the sole and the shoe. It is advisable at 
once to apply an energetic plaster, or, better still, to resort to firing in 
points. 

SUPPURATING OSTITIS, 

In addition to the changes in bone resulting from rachitis, osseous 
cachexia, tuberculosis, and actinomycosis, one sometimes sees cases of 
periostitis or ostitis pure and simple. As a result of external injury or 



30 BONE TUMOURS. 

direct wounds, the bone may be contused and injured, becoming the seat 
of diffused periostitis, necrosis, suppurating ostitis or osteomyelitis. 
Open fractures may produce the same results. 

Treatment comprises disinfection of wounds, antiseptic injection of 
fistulge, the application of antiseptic pencils, curettage, the removal of 
sequestra, and vesicant or resolvent complications. When such condi- 
tions extend to neighbouring joints and produce suppurative arthritis, 
the animals ought to be killed. 

BONE TUMOURS. 

The only bone tumours of real importance from a practical point of 
view are malignant growths represented by rapidly spreading epithelio- 
mata or sarcomata, originating in the periosteum. Fortunately such 
tumours are rare. 

They are not difficult to diagnose, as they develop rapidly, are accom- 
panied by pain and lameness ending in diminution or loss of the power 
of movement, and frequently attack neighbouring lymphatic glands. 
Even when in good condition, animals lose flesh and appetite, and finally 
die of general wasting. The diagnosis is sufficiently guided by the 
deformity of the parts, the bosselated appearance of the tumours, the 
absence of fluctuation, the haemorrhage which follows exploratory punc- 
ture, the character of the little fragments of tissue removed through 
these punctures, and finally the leukocytosis, which accompanies the 
development of malignant tumours. 

The prognosis is grave, for it is usually difficult or out of the question 
to have recourse to removal, resection or amputation, when the tumours 
have acquired any considerable size. Success is impossible unless 
intervention is early, and the growth is in a readily accessible part. In 
other circumstances early slaughter is indicated. 



CHAPTER II. 

DISEASES OF THE FOOT. 

CONGESTION OF THE CLAWS. 

Congestion of the claws is not infrequently confused with contusion of 
the sole. It is, however, essentially different, and presents closer 
analogies with laminitis. The condition is characterised by congestion of 
the entire vascular system of the claw and principally of the velvety 
tissue. Like laminitis, it affects all four limbs ; in rare cases the two 
front or two hind. 

Congestion of the claw results almost exclusively from enforced move- 
ment on hard, dry and hot ground. It is commoner in animals 
unaccustomed to walking, and in heavy beasts which have been travelled 
considerable distances to attend fairs or markets. It is commonest in 
the bovine and porcine species, and less common in sheep. 

The symptoms appear after animals return from a long journey by 
road. They are characterised by unwillingness to bear weight on the 
feet and difficulty in movement. Standing is painful, and the animals 
resist being moved; as soon as released they lie down. 

Diagnosis presents no difficulty, though the condition is sometimes 
mistaken for slight laminitis. 

Prognosis is favourable. 

Absolute and prolonged rest is always followed by recovery, no 
internal medication being necessary, though this result is promoted by 
enveloping the claws in wet compresses or by using cold foot baths, etc. 

CONTUSIONS OF THE SOLE. 

Contusions of the sole are only seen in animals which work without 
shoes or in such as are badly shod. 

Work on rocky ground, movement over newly metalled roads, and 
wounds produced by sharp stones, are the principal causes of contusion 
of the sole. Badly applied shoes, flat or slightly convex on their upper 
surfaces, may also produce bruising in the region of the sole. The 
anterior angle of the claw is rarely affected. 



32 CONTUSIONS OF THE SOLE. 

Lameness is the first symptom to attract attention. It is slightly 
marked, unless the bruising has been overlooked until suppuration has 
set in. It affects only one or two limbs, and is rarely accompanied by 
general disturbance, such as loss of appetite, fever, exhaustion during 
work, etc. 

Locally the claw or claws affected are abnormally sensitive to per- 
cussion of the wall, and particularly to compression of the sole. 

The parts are hot to the hand, and thinning the sole with a knife shows 
little perforations, irregular points and crevices in the horn. One 
may also find softening, infiltration and haemorrhage within the horn 
similar to those of corn in the horse, undermining of the sole over 
limited areas, and sometimes suppuration, if the animals have been 
forced to work when lame. 

Complications like necrosis of the velvety tissue or of the bone, though 
comparatively common in the horse, are rare in oxen. 

Diagnosis is not difficult provided the history of the case is known. 
Confusion w^ith laminitis is scarcely possible, for the gait of this lameness 
and the local symptoms are all different. Examination of the sole will 
usually dispel any remaining doubt. 

Prognosis. The prognosis is favourable. When the horn is simply 
softened and a blackish liquid transudes, the lesion is trifling; if the 
discharge is reddish grey the lesion is graver, and implicates all the 
velvety tissue ; finally, separation of the horn from the secreting 
membrane and the discharge of true pus point to death of the 
keratogenous tissue or of the bone. 

Treatment should be commenced by carefully thinning the sole 
around the wound and applying moist antiseptic dressings or cold 
affusions. Eemoval of loose portions of horn hastens repair by allowing 
discharge, which has accumulated between the living tissues and the horn 
itself, to escape freely. The extirpation of necrotic tissue and the appli- 
cation of surgical dressings are only called for in specially grave cases. 

This treatment usually gives good results. The acute complications 
which are so common and so dangerous in the horse seldom occur in 
the ox. 

Most of these operations can be performed without casting, provided 
the animal is placed in a trevis or is sufficiently secured. 

LAMINITIS. 

Laminitis is characterised by congestion, followed by inflam- 
mation of the horn- secreting tissues of the foot. It is now rare in 
oxen and very seldom assumes an acute form. The slow pace at which 
animals of the bovine species move may sufficiently explain this rarity ; 



LAMINITIS. 33 

nevertheless, prolonged travel on stony roads with heavy vehicles, rapid 
and repeated marches to towns or important fairs, are sufficient to pro- 
duce attacks. Before the days of railways, and for some time after 
their introduction, in Britain cattle were travelled by road, and laminitis 
was common. 

Long journeys in crowded railway trucks may also produce the disease, 
although the animal has not been forced to walk. Persons engaged in 
exhibiting cattle at shows are well aware of this. Prolonged main- 
tenance of the standing position will produce the trouble, to which 
the joltings of the railway journey may also contribute their share. 
Prolonged standing on board ship may induce laminitis. 

" Show condition " and the consumption of highly nitrogenous, and 
particularly of farinaceous, foods favour the occurrence of laminitis. 

Breed is also considered to have some influence, and laminitis is said 
to occur more frequently in animals raised in flat districts, because in their 
case the space between the digits is larger than in mountain-bred cattle. 
In this connection the body weight may perhaps play a certain part. 

The symptoms vary somewhat, depending on whether laminitis is 
general and affects all four feet, or restricted to the two front or the two 
hind feet. 

The internal claws always seem more severely affected and more sensi- 
tive than the external. In very rare cases the animal remains standing, 
but usually it lies down, and will only rise under strong compulsion. 

When standing, the symptoms are similar to those noted in the horse ; 
the animal appears as though absolutely incapable of moving. If all 
four feet are affected the animal assumes a position as though just about 
to rise ; if the front feet alone are affected the animal kneels in front 
whilst it stands on its hind legs, a very unusual position for the ox to 
assume ; finally, if the hind feet alone are affected, the animal seems to 
prefer a position with the feet under the body both in front and behind. 
(See Veterinarian, 1894, case by Bayley, and note by Nunn.) 

It is always difficult to make the animal move. Walking seems pain- 
ful, and most weight is thrown on the heels. The body swings from 
side to side as the limbs are advanced, and each limb is moved with a 
kind of general bodily effort. 

The claws are hot, sensitive to the slightest touch, and painful on 
percussion. 

Throughout the development of laminitis the general symptoms are 
very marked. The appetite falls oft' early, fever soon appears, and in 
grave cases the temperature rises to 105"^ or to 106° Fahr. Thirst is 
marked, and the animal seems to prefer cold drinks. The muzzle is dry, 
the face anxious and expressive of pain. Wasting is rapid. 

The ordinary termination is in resolution, which occurs between the 

D.C. D 



84 DISEASES OF THE FOOT. 

eighth and fifteenth day, provided the patient has been- suitably treated. 
The disease rarely becomes chronic. On the other hand, the claw occa- 
sionally separates, as a consequence of hgemorrhage or suppuration, 
between the horn proper and its secreting membrane. Should this 
complication threaten, the pastern becomes greatly swollen, the ex- 
tremities become intensely congested, and separation commences at 
the coronet. Loss of the claws, however, like suppuration, is rare. 

Diagnosis. Congestion of the sole, the early stage of infectious 
rheumatism and osseous cachexia may, at certain periods of their 
development, be confused with laminitis ; but the .history and the 
method of development of the above-mentioned diseases always allow 
of easy differentiation. 

It should, however, be added that, in certain exceptional conditions 
(suppurating echinococosis, producing chronic intoxication, tumours 
of the liver, and tumours of the pericardium and mediastinum), 
symptoms may be shown that suggest the existence of laminitis, 
although it is not really present. In these cases pain may possibly be 
felt in the bones of the extremities. 

The prognosis is usually favourable, but necessarily depends on the 
intensity of the disease. Fat stock always suffer severely. 

The treatment varies in no important particular from that prescribed 
for the horse, and is usually followed by rapid improvement. The chief 
indications are free bleeding from the jugular, the application of a 
mustard plaster over the chest, and the administration of a smart purga- 
tive (1 to 2 lbs. of sulphate of soda, according to the size of the animal) 
at first, followed by laxatives. This treatment may be completed by 
giving salicylate of soda 2^er os in doses of 5 to 8 drams, or arecoline in 
subcutaneous injection, 1 to IJ grains. Local treatment consists in cold 
affusions or poultices to the feet. 

Failing cold baths, clay plasters applied to the feet are useful. To 
ensure success all these methods should be utilised simultaneously. In 
cases of separation of the claw, antiseptic dressings, with a thick pad of 
tow placed under the sole, become necessary. 

Chronic laminitis may perhaps occur in the ox as in the horse, but, as 
a rule, oxen are slaughtered before the disease can assume this form. 
In dealing with fat, or even with fairly well-nourished, oxen it would 
clearly be more economical to slaughter early, and so prevent wasting 
and the resulting loss from disease. 

SAND CRACK. 

Sand crack — that is to say, the occurrence of vertical fissures in the 
wall of the claw — is not absolutely rare in bovines. It is commonest in 



SAND CRACK. 35 

working oxen drawing heavy loads, though in very exceptional cases it 
affects animals which have never worked. (Moussu describes one case 
in a young ox where four sand cracks existed simultaneously.) It may 
also result from injuries to the coronet. In contrast to the case of the 
horse, and owing to the different conditions under which the ox performs 
its work, the disease is commoner in front than in hind feet. In 
drawing, the ox's front limbs play the principal part, and the animal 
pivots, so to speak, on the claws of the front limbs. 

The position of the crack may vary. It is commonest on the inner 
surface of the claw, rare at the toe, and still rarer at the quarter. 
It is often superficial and complete, extending throughout the entire 
height of the claw, but not throughout its thickness ; sometimes it is 
complete and profound, the fissure then extending to the podophyllous 
tissue. 

The symptoms are purely local in the case of superficial lesions. 
When the injury is deep seated, or when it originates in a wound of the 
coronet, lameness is present. Intense lameness, swelling of the coronet, 
and blood-stained or purulent discharge point to grave "injury and 
probable complications. 

Diagnosis is easy. The prognosis naturally varies with the symptoms. 
It is favourable when the fissure is merely superficial, but becomes grave 
when it is deep seated and the animal is exclusively used for heavy 
draught. 

Treatment. When the lesion is superficial and unaccompanied by 
lameness, no surgical interference is necessary. Eest or very light work 
is alone required. As soon as lameness appears, rest is obligatory. The 
application of antiseptic poultices, containing 2J to 3 per cent, of carbolic 
acid, creolin, etc., usually alleviates pain in a short time, and facilitates 
healing in the depth of the fissure. 

In exceptional cases, where complications have occurred in conse- 
quence of suppuration beneath the fissure, suppuration in the coronary 
region, or necrosis of the podophyllous tissues, an operation becomes 
necessary, and is of exactly similar character to that performed under 
like circumstances in the horse. 

Over a space of 1 to IJ inches on either side of the fissure the horn 
is thinned '*to the blood," and the subjacent dead tissue removed. The 
claw is then thoroughly cleansed with some antiseptic solution, the 
wound freely dusted with equal parts of iodoform, tannin and boric 
acid, and covered with pads of tow or cotton wool, fixed in position by 
appropriate bandages. After such operations a long rest is essential 
for complete recovery, during which, however, the animal may be 
fattened. 

The object of operation is to prevent complications, like chronic 

D 2 



36 DISEASES OF THE FOOT. 

suppuration and necrosis, which would endanger the animal's life, rather 
than to effect perfect restoration of usefulness for the work previously 
done. 

PRICKS AND STABS IN SHOEING, 

The wall of the ox's claw is so thin that shoeing is always somewhat 
difficult, more especially as nails can only he inserted in the external 
wall. Moreover, as very fine nails must be used, they are apt to bend, 
penetrate the podophyllous tissue, and cause injuries of varying import- 
ance. The ox is often very restless when being shod, and, even though 
firmly fixed, usually contrives to move the foot every time the nail is 
struck. The farrier, therefore, may easily overlook the injury which he 
has just caused, and by j)i'oceeding and ignoring it may transform a 
simple stab into a much more dangerous wound. 

Symptoms. In most cases lameness appears immediately the animal 
leaves the trevis, but, although this is more difficult to explain, lameness 
is sometimes deferred until the day after, or even two days after, shoeing. 
Though little marked at first, lameness may become so severe that the 
animal cannot bear the pain caused by the foot touching the ground. 
When this stage is reached general disturbance becomes marked, fever 
sets in, rumination stops, and appetite is lost. 

These symptoms point to the occurrence of suppuration. The ]3us, 
confined within the horny covering of the foot, causes very acute suffering 
and sometimes grave general disturbance ; later it burrows in various 
directions, separating the podophyllous tissue from the horn, and ends by 
breaking through '' between hair and hoof " in the region of the coronet. 
In exceptional cases, complications such as necrosis of the podophyllous 
tissue extending to the bone, and suppuration of its spongy tissue, may 
be observed. 

Diagnosis. When the farrier suspects he has pricked an animal 
the immediate withdrawal of the nail will remove any doubt, because 
bleeding usually follows. If the condition is only detected at a later 
stage, the early lameness having been misinterpreted, examination of 
the claw and taj^ping the clenches of the nails wdll cause the animal 
to show pain at a given point, thus indicating the penetration of the 
nail. Removal of the offending nail is painful, and is often followed by 
discharge of pus or blood-stained fluid, which clearly points to the 
character of the injury. In obscure cases the shoe should not be 
reapplied. 

When the horn wall is separated from the sensitive structures, there is 
marked general disturbance, and pus is discharging at the coronet, it is 
practically impossible to err in diagnosis. 

Prognosis. In cases of simple nail puncture the prognosis is hopeful, 
provided that the condition is at once diagnosed. The longer it remains 



PRICKS AND STABS IN SHOEING. 37 

unrecognised, particularly if complication like necrosis has occurred, the 
graver becomes the outlook. 

Treatment. In cases of simple puncture the nail should immediately 
be withdrawn and the animal placed on a perfectly clean bed to prevent 
the wound becoming soiled or infected. If lameness appear and become 
aggravated, the shoe should be removed and antiseptic poultices applied. 
In the majority of cases the lameness will then diminish, and in a few 
days completely disappear. 

In cases of discovery within the first few days the same treatment is 
applicable, and is often sufficient. If, on the contrary, pus is discharging 
at the coronet, if lameness is intense and the general symptoms marked, 
it may be needful to operate. 

The stages of operation comprise : thorough thinning of the horn in the 
shape of an inverted V over the affected portion of the wall, removal of 
the loose necrosed parts, disinfection of the wound, and the application 
of a surgical dressing covering the entire claw. 

PICKED'UP NAILS, Etc. C* GATHERED NAIL/0 

Penetrating wounds of the plantar region are, as in the horse, usually 
included under the heading of " Picked-up Nails." They are only seen 
in oxen or cow^s which are not shod. Pointed objects, like nails, harrow 
teeth, sharp fragments of wood or glass, etc., may jDroduce injuries of 
the character of that now in question. 

In considering the position of such wounds we may for convenience 
divide the plantar region into two zones, one extending from the toe of 
the claw to the point of insertion of the perforans tendon, the other 
comprising the region betw^een this insertion and the bulb of the heel. 

Symptoms. Lameness occurs immediately, and varies with the in- 
tensity of the existing pain. If the offending body has not remained 
fixed in the w^ound, this lameness may in a few moments disappear, 
either for good or merely for a time. The recurrence of lameness on 
the following day or a couple of days later marks the commencement 
of inflammatory changes in the deeper seated tissues. This lameness 
in many instances is accompanied by a movement suggestive of string- 
halt, the foot being kept on the ground only for a very short time, or 
sometimes not being brought into contact with the ground at all. 

The depth to which the offending object has penetrated, and the 
direction it has taken, may sometimes be discovered by a mere casual 
examination of the sole. In other cases only the orifice by which it has 
penetrated can be found. If the injury has existed for several days, the 
discharge from the puncture will be thin and blackish, purulent, or 
blood-stained, according to the case. Fever and general systemic dis- 
turbance suggest an injury of a grave character. 



38 DISEASES OF THE FOOT. 

Diagnosis. The diagnosis is easy, inasmuch as the lameness almost 
directs examination to the foot. 

Prognosis is rarely grave. The direction, the situation and mode of 
insertion of the flexor tendon, which forms the plantar aponem^osis, 
ensm^e this aponem^osis being rarely injured by objects penetrating from 
without. The points of the offending bodies usually pass either forwards 
to the phalanx or backwards in the direction of the plantar cushion. 

Treatment. The first stage in treatment consists in removing the 
foreign body and thoroughly thinning the neighbouring horn. An 
antiseptic poultice consisting of linseed meal saturated with 3 per cent, 
carbolic acid or creolin solution is then applied. Considerable and pro- 
gressive improvement usually takes place in a few hours. If lameness 
persists, surgical interference becomes necessary ; in the anterior zone 
it is confined to removing any dead portions of the velvety tissue and to 
extirpating the fragment of bone which has undergone necrosis. In the 
posterior zone the sinus must be probed and laid open, so that all the 
diseased parts can be treated as an open wound. 

If, as happens in exceptional cases, the plantar aponeurosis is found 
to be severely injured, the complete operation for picked-up nail, as 
practised in the horse, may be performed, or the claw may be ampu- 
tated. In the former operation the horn covering the sole is first 
thinned '' to the blood." 

The stages of operation 'are as follows : — 

(1.) Ablation of the anterior j^ortion of the plantar cushion. Trans- 
verse vertical incision at a distance of IJ inches in front of the heel ; 
excision of the anterior flap. 

(2.) Transverse incision and ablation of the plantar aponeurosis by 
the same method. 

(3.) Curettage of the point of implantation of the aponeurosis into 
the bone. 

(4.) Antiseptic dressing of the claw. 
Finally, if the primary lesion, wherever it may have started, has 
become complicated by arthritis of the interphalangeal joint, it will 
be necessary to remove the claw, or, better still, to remove the two 
last phalanges, the latter o^^eration being easier than the former, and 
providing flaps of more regular shape and better adapted for the 
production of a satisfactory stump. 

INFLAMMATION OF THE INTERDIGITAL SPACE. 
(CONDYLOMATA.) 

Condylomata result from chronic inflammation of the skin covering 
the inter digital ligament. Any injury to this region causing even 
superficial damage may result in chronic inflammation of the skin 



INFLAMMATION OF THE INTERDIGITAL SPACE. 



39 



and hypertrophy of the papillae, the first stage in the production of 
condylomata. 

Injuries produced by cords slipped into the interdigital space for 
the purpose of lifting the feet when shoeing working oxen are also 
fruitful causes. 

Inflammation of the interdigital space is also a common complication 
of aphthous eruptions around the claws and in the space between them. 
Continual contact with litter, dung and urine favour infection of super- 
ficial or deep wounds, and by causing exuberant granulation lead to 
hypertrophy of the papillary layer of the skin. When the .animal 
stands on the foot the claws separate under the pressure of the body 
weight and the condylomata are relieved of pressure. When, however, 
the limbs are rested, the claws mutually approach, compress the 





Fig. 16. — Condylomata of the interdigital space and sidebones, 

abnormal vegetations, flatten, excoriate, and irritate them, thus favouring 
their further development. 

The symptoms are easy to detect. The animals appear in perfect 
health, but have difficulty in walking, and show pain. They walk as 
though on sharp, rough ground, and lameness is sometimes severe. 
Locally, the anterior surface of the claws and the interdigital _ space 
are markedly congested and sensitive, or painful on pressure. The 
growths are of varying size, isolated or confluent, bleeding, excoriated, 
or covered with horn, and are visible between the claws when the animal 
stands on the limb. In many cases they form a perfect cast of the 
vertical interspace. When the superficial layers have undergone 
conversion into a horn-like material, lameness diminishes or disappears. 

Diagnosis presents no difficulty. 

Prognosis is only grave in so far as the condition interferes with 
animals working, but it may render working oxen entirely useless. 

Treatment in the early stages is of a preventive character, and 
consists in placing animals which have been accidentally injured or 
attacked with foot-and-mouth disease on a perfectly clean bed. 



40 DISEASES OF THE FOOT. 

Surgical treatment is the only reliable method in cases where hyper- 
trophy of the papillary layer is well marked, and is extremely simple. 

The animal should be fixed in the trevis, the foot to be operated on 
separately secured, and the growths completely removed with sharp 
scissors or with a bistoury and forceps. When bleeding has subsided 
the wound is covered with a mixture of equal parts of iodoform, tannin, 
and powdered boric acid, and an interdigital dressing is applied. The 
dressing is removed after five to ten days, according to circumstances. 
If the cicatrix shows signs of exuberant growth it is dusted with 
powdered burnt alum, and the parts are treated as an open wound. 
When the growths are covered with horn and no longer painful it is 
not desirable to interfere with them. 

CANKER, 

Canker — i.e., chronic suppurative inflammation of the podophyllous or 
velvety tissue — is accompanied by hypertrophy of the papillae and pro- 
gressive separation of the horn of the sole. It is much rarer in the ox 
than in the horse, although it occasionally occurs. 

Prolonged retention in dirty stables, where the bedding is mixed with 
manure and continually moistened with urine, is the principal cause of 
the disease. Individual predisposition and the action of some specific 
organism may also have some influence. 

Canker in oxen, like the same disease in horses, is recognised by 
softening and separation of the horn of the sole, and by progressive 
extension of the process towards neighbouring parts. The usual course 
consists in invasion of the podophyllous tissue, separation of the wall and 
of the heels, and pathological hypertrophy of the horn-forming tissues, 
p)roducing condylomata. 

The new growths do not attain the same dimensions as in the horse, 
but, on the other hand, the disease very frequently takes a progressive 
course, involving the whole of the claw. A trifling accidental injury may 
be followed by infection of the subungual tissues, and thus become the 
point of origin for canker. 

Canker may attack only one claw ; on the other hand, it may extend 
to both claws of one foot, or to the claws of more than one foot in the 
same animal. 

Diagnosis. Diagnosis is easy. The separation of the horn, the 
presence of a caseous, greyish-yellow and offensive discharge between 
the separated parts and the horn-secreting tissues, the appearance of 
the exposed living tissues, etc., leave no room for doubt. 

Prognosis. The prognosis is grave; for, as in the horse, the disease 
is obstinate. 



PANARITIUM — FELON — WHITLOW. 41 

Treatment consists in scrupulously removing all separated horn, so 
as fully to expose the tissues attacked by the disease. The parts should 
then be thoroughly disinfected with a liquid antiseptic, and a protective 
pressure dressing applied. 

As a rule, cauterisation with nitric acid, followed by applications of 
tar or of mixtures of tannin and iodoform, iodoform and powdered burnt 
alum, etc., effect healing, without such free use of the knife as has been 
recommended in the horse during the last few years. 



GREASE, 

Grease in the ox seems only to have been described by Morot and 
Cadeac, and even in these cases the descriptions appear rather to apply 
to elephantiasis or fibrous thickening of the skin than to grease proper. 
Tbe descriptions are not sufficiently clear, and the symptoms described 
differ too much from the classical type seen in the horse to convince us 
without further confirmation of the occurrence of the disease. 



PANARITIUM-FELON— WHITLOW. 

Any injury in the inter digital space or flexure of the pastern may, 
under unfavourable circumstances, be complicated by death of the skin, 
necrosis of the interdigital ligament, of the fibro-fatty cushion in the 
flexure of the pastern, and of the terminal portions of the tendons. 

These lesions are sometimes regarded as panaritium. In reality, 
they correspond exactl}^ to what, in the horse, are known as "cracked 
heels" and ''quittor." The primary injury becomes infected with 
organisms which rapidly cause death of the skin or the formation of a 
deep-seated abscess and necrosis of the invaded tissues. 

Causation. Neglect of sanitary precautions and filthy stables con- 
stitute favouring conditions, the feet being continually soiled and irritated 
by the manure and urine. Auimals reared on plains, and having broad, 
flat, widelj^-separated claws, are more predisposed than animals from 
mountainous regions, in which the interdigital ligament is stronger and 
the separation of the- claws less marked. Any injury, abrasion, or cut 
may serve as a point of origin for such complications. 

Panaritium may even occur as an enzootic with all the characters 
noted in isolated cases. In Germany it has received the name of "con- 
tagious foot disease." These enzootic outbreaks of panaritium follow 
epizootics of foot-and-mouth disease, with lesions about the claws. 
Through the superficial aphthous lesions the parts become inoculated 
with bacteria, and the severity of the resulting injury is in some 
measure an indication of the virulence of the infecting organism. 



42 DISEASES OF THE FOOT. 

Symptoms. The first important symptom consists in intense local 
pain, rapidly followed by marked lameness. The affected region soon 
becomes swollen ; the coronary band appears congested ; the skin of the 
interdigital space projects both in front and behind ; the claws are 
separated, and all the lower portion of the limb appears congested 
and (Edematous. The engorgement usually extends as high as the 
fetlock, and the parts are hard and extremely sensitive. The patient 
is feverish, loses appetite, and commences to waste. After five to ten 
days sloughing occurs at some point — if the ligament is affected, in the 
interdigital space ; if the tendons, or the fibro-fatty cushions, the slough 
appears in the flexure of the pastern. The dead tissue may separate and fall 
away, or remain in position macerated in pus. Separation is generally slow, 
requiring from twelve to fifteen days, and, unless precautions are taken, 
complications occur. If only the interdigital ligament or fibro-fatty 
cushion be necrotic, recovery may be hoped for ; but, on the other hand, 
if the tendons, tendon sheaths, ligaments, or bones are affected, complica- 
tions like suppurating synovitis, suppurating ostitis, arthritis, etc., super- 
vene, with fatal results. Death may occur from purulent infection, unless 
the animal is slaughtered early. 

The diagnosis is easy. The intensity of the lameness, separation of 
the claws, swelling of the pastern region, sensitiveness of the swollen 
parts, and absence of lesions in the ungual region sufficiently indicate 
the nature of the condition. 

The prognosis is grave, for complications may result, in spite of 
proper treatment. 

Treatment. Treatment consists, first of all, in thoroughly cleansing 
the affected limb and placing the animal on a very clean bed. The parts 
are next subjected to antiseptic baths containing carbolic acid, creolin, 
sulphate of zinc, or sulphate of copper. It is often more convenient, and 
quite as efficacious, to apply antiseptic poultices to the foot and pastern, 
and to allow them to remain for some days, being moistened several 
times daily with one of the solutions indicated. The effects are: rapid 
diminution of the pain, delimitation of the necrotic tissues is hastened, 
and the abscess is more readily opened. 

Many practitioners recommend early intervention in the form of 
deep scarification in the interdigital space or pastern region. The 
local bleeding, and the drainage which takes place through the wounds 
so made, is said to hasten recovery or to prevent complications. 

When the abscess has opened, and the dead tissue separated, the 
abscess cavity or wound should be regularly washed out with a disin- 
fecting solution, to prevent complications, in case fragments of necrotic 
tissue have been retained. If, however, complications have occurred, no 
hesitation should be felt in freely incising the parts, and, if necessary, in 



FOOT EOT. 43 

removing one or both phalanges. When both jomts of one foot are 
affected, and arthritis threatens to or has set in, there is no object in 
treating the animal, and early slaughter is to be recommended. 

In cases where the disease follows foot-and-mouth disease, and 
threatens to become enzootic, it can generally be prevented spreading 
by keeping the foot-and-mouth subjects on very clean beds, and 
frequently washing the feet with antiseptic solutions. Disinfection of 
the sheds is also very desirable. 

FOOT ROT. 

Foot rot is a disease of sheep, and, like canker, is confined to the 
claws. 

Thanks to the progress of hygiene, it tends to become rarer, bat is 
still seen in the enzootic form in some portions of England and Scotland, 
in the mountains of Vivarais, the Cevennes, and the Pyrenees. 

It affects large numbers of animals at once, animals belonging to one 
flock or to neighbouring flocks in one locality, and when it invades a 
sheep farm, all the animals may successively be attacked at intervals, 
according to the local conditions. 

Symptoms. The disease develops rather insidiously, and the patients 
always retain an excellent apj)etite. It begins with lameness, which is 
at first slight, later becomes accentuated, and in the last periods is very 
intense. On examination, the coronet and lower part of the limb as 
high as the fetlock are found to be swollen. Palpation reveals exaggerated 
sensibility, and on direct examination, a foetid, discharge is discovered in 
the interdigital space. This discharge, which is peculiar to the onset of 
the disease, only continues for a week or two, and is succeeded by a 
caseous exudate which is always offensive, which moistens and macerates 
the horn, the skin, the tissues in the interdigital space, and the region of 
the heels. From the 20th to the 30th day after onset the claw separates 
above in the interdigital space. The separation extends towards the 
heel, then to the toe, exposing ulceration of the subjacent podophyllous 
tissue. 

From this time the patients experience very severe pain, and, as in 
other diseases of the feet, remain lying for long periods. Movement 
becomes extremely painful, and the animals frequently walk on the knees. 
The subungual lesions become aggravated, separation of the claw 
extends, necrosis of the podophyllous tissue and of subjacent tissue 
becomes more extensive, and the interphalangeal ligaments and the 
extensor or flexor tendons become involved. Finally, the claws are lost, 
and synovitis and arthritis are added to the complications already existing. 

In an infected locality the development is always the same. The 



44 DISEASES OF THE FOOT. 

animals lose flesh, become anaemic, and, miless vigorously treated, soon 
die. The ordinary duration of the disease is from five to eight months, 
sometimes more. If, however, patients are isolated and well treated 
they recover. 

Causation. The specific cause of foot rot still remains to be dis- 
covered, although everything points to the conclusion that it consists 
in an organism capable of cultivation in manure, litter, etc., for foot rot 
is transmissible by cohabitation, by mediate contagion through infected 
pasture, by direct contact and by inoculation. 

The chief favouring influences are bad drainage, filthy condition of 
the folds, and herding in marshy localities. 

Diagnosis. The condition can scarcely be mistaken, for the sheep 
suffers from no other disease resembling it, excepting, perhaps, foot-and- 
mouth disease. 

Prognosis. The prognosis is grave, for the disease usually assumes 
a chronic course, aftects entire flocks, and the patients require individual 
attention. 

Treatment. The primary essential to success in treatment consists 
in separating and isolating the diseased animals in a scrupulously clean 
place and providing a very dry bed. 

In the early stages the disease may be checked by astringent and 
antiseptic foot baths. It is then sufficient to construct a foot-bath at the 
entrance to the fold, containing either milk of lime, 4 per cent, sulphate 
of iron, copper sulphate, creolin, etc. , Through this the sheep are passed 
two or three times a week. These precautions rarely suffice when the 
feet are already extensively diseased ; and when the horn is separated to 
any considerable extent, surgical treatment is indispensable. All loose 
portions of horn should be removed and antiseptic applications made to 
the parts. 

When a large number of sheep are affected the treatment is very 
prolonged, but it is absolutely indispensable, and the numerous dressings 
required necessarily complicate the treatment. It would be valuable to 
experiment Avith small leggings, which would retain the dressings in 
position, and, at the same time, shelter the claws from the action of the 
litter, while favouring the prolonged action of the antiseptic. 

When the lesions are not extensive, a daily dressing is sufficient. 

Among the materials most strongly recommended are antiseptic and 
astringent ointments containing carbolic acid, iodoform, or camphor. 
Yaseliue with 5 per cent, of iodine is very serviceable, and much to be 
preferred to applications like copper sulphate, iron sulphate, etc. Its 
greatest drawback is its expense. 



CHAPTER III. 

DISEASES OF THE SYNOVIAL MEMBRANES AND 
OF THE ARTICULATIONS. 

I._SYNOVIAL MEMBKANES AND AKTICULATIONS. 

SYNOVITIS, 

Inflammation of the synovial membranes, or synovitis, may affect the 
synovial sacs either of the joints or of the tendon sheaths. It may be 
acute or chronic and occur either idiopathically or follow the infliction of 
an injury. Its two chief forms are simple, or "closed," synovitis and 
suppurative, or " open," synovitis, the essential distinction between which 
is that in the latter micro-organisms are present, whilst in simple 
synovitis they are absent. In all cases the disease is characterised by 
distension of the sac affected. 

Synovitis produced by a wound communicating with the outer air 
may be complicated by suppuration, and if the S3movial membrane of a 
joint be involved the primary synovitis is almost always followed by 
traumatic arthritis. 

The commonest forms of chronic simple synovitis are : — 

INFLAMMATION OF THE PATELLAR SYNOVIAL CAPSULE. 

Inflammation of the synovial membrane of the femoro-patellar joint 
is most commonly seen in working oxen as a consequence of strains 
during draught. It is also found in young animals which have 
injured the synovial capsule through falls, slips, or over-extension of 
the limb. 

Symptoms. Development is slow and progressive, and injury may 
not be discovered until the lameness which follows has become fairly 
marked. This lesion is characterised by swelling in the region of the 
stifle. On palpation, fluctuation may readily be noted both on the outer 
and inner surfaces of the joint. The exudate is sometimes so abundant 
and distension so great that the straight ligaments, the neighbouring 
bony prominences, and the ends of the tendons are buried in the liquid 
swelling. 

Lameness, which is at first marked, often diminishes with exercise. 
The length of the step is lessened. 



46 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

Diagnosis. The diagnosis presents no difficulty, but the lesions 
must be distinguished from those due to tuberculosis in this region, 
rheumatic arthritis, and the specific arthritis seen in milch cows. 

The prognosis is grave, for the disease renders animals useless 
for work. 

Treatment. Rest, cold moist applications, and massage constitute 
the best treatment in the early stages. Should swelling persist, one 
may afterwards apply a smart blister or even tap the joint aseptically, 
drawing off the fluid and then applying the actual cautery. Irritant 
injections must be avoided. 

DISTENSION OF THE SYNOVIAL CAPSULE OF THE HOCK JOINT, 

Bog Spavin in the Ox. 

Bog spavin is frequent in working oxen and in oxen from three to 
five years old. It is due to strain in draught or to strain produced in 
rearing up at the moment of covering. Old bulls, heavy of body, and 
stiff in their limbs are predisposed to it. 

Symptoms. The symptoms usually develop gradually and without 
lameness, but sometimes declare themselves more rapidly with lameness, 
accompanied by marked sensitiveness on palpation. At first the hock 
shows a generalised doughy swelling, soon follo^ved by dilatation of the 
articular synovial sac. Somewhat later four different swellings appear — 
two in front, separated by the tendons of the common extensor and 
flexor metatarsi, and two at the back, extending inside and outside to the 
flexure of the hock. 

Diagnosis. The only precaution required in diagnosis is to avoid 
confusion with articular rheumatism. 

Prognosis. The prognosis is rather grave in the case of working 
oxen, and even of bulls ; often slaughter is preferable to treatment. 

Treatment diflers in no respect from that of distension of the stifle- 
joint. In young bulls aseptic puncture and drainage of the joint, 
followed by the application of the actual cautery, probably give the 
best results. 

DISTENSION OF TENDON SHEATHS IN THE HOCK REGION. 

Like the preceding, this condition is rarely seen except in bulls and 
working oxen. It is characterised by dilatation of the upper portion of 
the tarsal sheath, one swelling appearing on the outer side, the other on 
the inner. 

The differential diagnosis is based on the position of these synovial 
sacs, which are quite close to the insertion of the tendo-Achillis, and on 
the absence of any swelling in front of the joint. 



DISTENSION OF THE SYNOVIAL CAPSULE OF THE KNEE JOINT. 47 

Treatment is identical with that indicated in the last condition. 
Massage and cold water applications should be employed at first, to 

be followed by aseptic puncture and withdrawal of fluid, supplemented if 

necessary by firing in points. 

DISTENSION OF THE SYNOVIAL CAPSULE OF THE KNEE JOINT. 

This is one of the rarest conditions now under consideration, because 
the synovial membranes of the knee joint are everywhere strongly 





Fig. 17. — Front view of the ox's 
hock, showing the relations of 
the tendons and synovial sacs. 



Fig. 18. — Side view of the ox's hock. The sjno- 
vial sac of the true hock joint has been injected 
to show the relations of the sacs. 



supported by very powerful ligaments. The synovial capsules of the 
carpo-metacarpal and inter-carpal joints are incapable of forming sacs 
of any size. On the other hand, the radio-carpal may become moderately 
prominent in front, especially towards the outside above the superior 
carpal ligament. When weight is placed on the limb, the excess of 
synovia is expelled from the joint cavity towards this little sac, which 



48 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

then becomes greatly distended. If, on the other hand, the knee is bent, 
the sac shrinks or disappears. 

Treatment. Treatment is restricted to the appHcation of a bKster or 
to firing in points. 

DISTENSION OF THE SYNOVIAL CAPSULE OF THE 
FETLOCK JOINT. 

The synovial capsule of the fetlock joint in the ox is strongly sup- 
ported in front and at the sides, but may protrude under the anterior 
ligament, producing a swelling behind the metacarpus under the five 
branches of division of the suspensory ligament and slightly below the 
sesamoid bones. These distensions, like bursal swellings, are commoner 
in hind limbs and in old working oxen. Their development is always 
followed in time by a certain degree of knuckling over. At first the 
metacarpus and phalanges come to form a straight line, but later the 
fetlock joint itself is thrust forward. 

The diagnosis necessitates careful manual examination of the region 
of the fetlock joint. 

The prognosis is somewhat grave, for the disease sooner or later 
necessitates the destruction of certain animals. 

Treatment is practically identical with that used in all such con- 
ditions : friction with camphorated alcohol, cold affusions and massage 
in the earlier stages, followed if needful by blisters or firing in points. 

DISTENSION OF TENDON SHEATHS. 

Distension of the synovial capsule which surrounds the superior 
suspensory ligament, like distension of the articular capsule of the 
fetlock, occurs in working animals, and most commonly affects the front 
limbs. It is indicated by two swellings, one situated on either side of 
and behind the branches of division of the suspensory ligament and in 
front of the flexor tendons. These two swellings extend higher than the 
articular swellings, which, however, they sometimes accompany. The 
surface of the fetlock is then swollen, doughy on pressure, and some- 
what painful. 

These enlargements may produce more or less marked lameness and 
cause knuckling. 

The diagnosis is clear from local examination. 

The prognosis is unfavourable, as the animals after a time become 
useless for work. 

Treatment. The beginning of the disease may often be cured by 
baths of running water, combined with massage. At a later stage, local 
stimulants, bhsters, or firing are necessary. The best treatment 



TRAUMATIC SYNOVITIS — '^ OPEN SYNOVITIS." 49 

probably consists in puncturing the parts with antiseptic precautions, 
washing out the synovial cavity with an antiseptic, and immediately 
afterwards lightly firing the surface of the region in points. 

DISTENSION OF TENDON SHEATHS IN THE REGION 
OF THE KNEE. 

Any of the numerous tendon sheaths which facilitate the gliding of 
tendons in the neighbourhood of the knee may become inflamed 
and give rise to a chronic synovial swelling. The commonest of 
such swellings is due to distension of the sheath of the extensor 
metacarpi magnus, which appears as a vertical line in front of the 
knee, extending from the lower third of the forearm and slightly to 
the outer side of the central line. This synovial enlargement arises in 
oxen working on broken roads, in clay or marshy soils, where the 
animals are liable to stick fast, and are often obliged to struggle 
vigorously in order to extricate themselves. 

The diagnosis is based on the position and direction of the dilated 
synovial sheath. 

Treatment is identical with that of other cases of chronic synovitis. 

DISTENSION OF THE BURSAL SHEATH OF THE FLEXOR 

TENDONS. 

This condition is rare. It is announced, as in the horse, by a 
dilatation of semi-conical form, the apex of which is situated opposite the 
lower margin of the carpal sheath, the base extending as high as the 
infero-posterior third of the radius. 

The dilatation is more marked on the inner than on the outer side 
of the limb. 

Distension of the synovial sheath of the common extensor of the 
digits in the fore limb and of the extensor of the external digit is still 
rarer than the preceding conditions. 

TRAUMATIC SYNOVITIS— '* OPEN SYNOVITIS.'^ 

When an injury in the neighbourhood of a joint penetrates deeply, it 
may implicate either the synovial sheath of a tendon or the synovial 
membrane of a joint. If the body inflicting the wound is aseptic, a 
condition which in accidental wounds is rare, the wound may have no 
grave consequences. Usually, however, the body producing the injury 
is infected, and the infection rapidly extends throughout the tendon 
sheath or synovial sac. In the first case, traumatic suppurating synovitis 
of a tendon sheath is the result ; in the second, a suppurating articular 
synovitis arises, which soon becomes complicated with injury of the 
articular cartilages, ligaments, etc. (traumatic arthritis). 

D.C. E 



50 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

The primary lesion may only affect the periarticular region, not 
directly extending to the synovial membranes, and only after an interval 
of some days may symptoms of suppurating synovitis or suppurating 
arthritis appear, in consequence of progressive invasion of the parts by 
specially virulent microbes. 

TRAUMATIC TENDINOUS SYNOVITIS. 

Suppurative inflammation of the synovial bursae of tendons in conse- 
quence of wounds most commonly affects the sesamoid sheaths of the 
front or hind limbs ; more rarely, the tendon sheaths of the hock or 
knee ; and, exceptionally, the small synovial sheaths of the extensors of 
the metacarpus and phalanges, etc. 

Such inflammation follows injuries with forks, harrow teeth, or any 
sharp foreign body. It is characterised by the existence of a fistula or 
wound, indicating the course taken by the body inflicting the injury, 
from which at first normal synovia escapes. Later, however, the 
discharge becomes turbid, and after the second day gives place to a 
clotted, serous, or purulent fluid. 

A diffuse, oedematous, warm, painful swelling very raj)idly develops 
around the injury. The animal is more or less feverish and lame. The 
swelling soon extends throughout the entire length of the infected 
synovial sheath. The patient loses appetite, and unless treatment is 
promptly undertaken, complications supervene which often necessitate 
slaughter. The prognosis is always grave. 

Treatment. Continuous irrigation has long been recommended. It 
is worthy of trial, but in the majority of cases occurring in current 
practice it cannot be carried out. 

Moussu prefers a form of treatment which he claims has always 
succeeded in horses and oxen — viz., irrigation of the parts, followed by 
injection of sublimate glycerine solution. 

He first washes out the infected synovial cavity with boiled water 
cooled to 100° Fahr. A counter-opening may become necessary, and 
the washing should be continued until the escaping water appears 
perfectly clear. Immediately after each such irrigation he injects from 
7 to 14 drams of glycerine containing 1 part in' 1,000 of corrosive 
sublimate. He repeats this treatment daily. 

By reason of its affinity for water and for the liquids in the tissues or 
suppurating cavities into which it is injected, the glycerine penetrates 
in all directions, reaching the fijiest ramifications of the synovial sacs, a 
fact which explains its superiority over aqueous antiseptic solutions. 

Suppuration is rapidly checked and repair becomes regular. The 
pain and lameness progressively diminish, and recovery may be complete. 



TRAUMATIC ARTICULAR SYNOVITIS — TRAUMATIC ARTHRITIS. 



51 



It is advisable to assist this internal antiseptic treatment by external 
stimulants and by the use of a blister. Solutions of greater strength 
than 1 part of sublimate to 500 of glycerine are only required during the 
first few days of treatment and until suppuration diminishes. Later, 
they prove irritant, and interfere with healing. • 

TRAUMATIC ARTICULAR SYNOVITIS-TRAUMATIC ARTHRITIS— 

^'OPEN ARTHRITIS/' 

It has been described above how primary inflammation of the 
articular synovial membrane 
produced by a wound may 
rapidly develop into sup- 
purating arthritis. 

Symptoms. The pain is 
very marked at the moment 
when the accident occurs, 
but this pain, due to the 
mechanical injury inflicted, 
diminishes or completely dis- 
ajDpears after some hours. 
Soon, however, synovial dis- 
charge sets in, announcing 
the onset of traumatic syno- 
vitis. At first limpid, it 
soon becomes turbid, then 
curdled, and finally grumous, 
purulent and greyish in 
colour. 

Pain then returns, rapidly 
becomes intense, continuous 
and lancinating. It produces 
lameness, sometimes so severe 
that no weight whatever can 
be borne on the limb. A 
diffuse, oedematous, warm and 
extremely sensitive swelling 
then rapidly develops around 
the whole of the injured joint. 

General disturbance, with fever and loss of appetite, appears, indicating 
a very alarming condition. 

It is sometimes a little difficult to differentiate between this condition 
and that due to injury of a tendon sheath, but as a rule diagnosis is easy. 

Prognosis is very grave. Life is threatened, and wasting occurs very 

E 2 





Fig. 19. — Suppurative arthritis of the fetlock. 



52 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 



rapidly. Infection of the synovial membrane is soon followed by 
necrosis and erosion of the articular cartilages, as well as by softening 
and inflammatory change in the ligaments, etc. 

Treatment. Should the patient be in reasonably good condition, but 
otherwise of no particular value, it should at once be slaughtered. If, on 
the other hand, it possess a special value, and the owner wish to preserve 

its life, the same antiseptic 
treatment should be adopted 
as was indicated in dealing 
with suppurating synovitis of 
tendon sheaths. The loss of 
the articular cartilage of the 
joint is followed by free granu- 
lation and union of the apposed 
surfaces of bone resulting in 
anchylosis of the joint and 
qualified recovery. Such re- 
sults, however, are only likely 
to follow in relatively light 
animals w^hich are capable of 
standing for considerable 
periods. 






^ 1 




V' 






II.— STEAlNS OF JOINTS. 

When, in consequence of 
muscular contraction or ex- 
ternal violence, the bony sur- 
faces constituting a joint are 
displaced so as to stretch, 
lacerate, or partially tear the 
ligaments, synovial capsule or 
tendons supporting the joint, 
so-called sprain, or strain, or 
wrench results. The articular surfaces are not sufficiently displaced to 
cause luxation, but a series of periarticular injuries result, and are 
followed by the symptoms which we recognise as those of strain. Joints 
in which movement is restricted wdthin narrow limits, such as the hock 
or fetlock, are most liable to such injuries, which also occur in very freely 
movable articulations like the shoulder and stifle. 



Fig. 



20. — Suppurative arthritis following 
traumatic osteo-periostitis. 



STRAIN OF THE SHOULDER. 

This accident is produced by the animal falling on its side, by slipping 
at the moment of landing, the limb being extended and in contact with 



STRAIN OF THE KNEE. 53 

the ground, by the foot shppiDg at the moment when it is leaving the 
ground and the limb is at its extreme limit of backward extension, by 
side slips, etc. The periarticular lesions will then be found on the 
front, back, or internal surface of the articulation, depending on the 
manner in which the accident has occurred. According to some authors, 
violent muscular efforts, as well as work in soft clay soil, bogs and rice 
swamps, are also capable of causing strain of the shoulder. 

Symptoms. At first moving appears difficult, the patient lies down 
a great deal, then lameness becomes characteristic. Movement of the 
scapulo-humeral joint being painful, the patient endeavours as far as 
230ssible to avoid it ; the limb is advanced stiffly in an abducted position 
and with a mowing movement. This semi- circular movement avoids 
the necessity of flexing the scapulo-humeral angle, but diminishes the 
length of the stride. 

Locally, the region of the scapulo-humeral angle is swollen, doughy, 
and extremely sensitive on manual examination. If the practitioner 
endeavours to flex it by lifting the limb the animal flinches. 

Diagnosis. The diagnosis is not very difficult, although the peculiar 
mowing movement is also seen in other cases, such as cracked heels and 
mallenders. 

Prognosis. The prognosis is favourable, for, provided there has been 
only a moderate strain of the tendons or isolated injury to the muscles, 
recovery is almost certain. 

Treatment. Treatment consists in resting the animal and in 
assisting repair. 

The parts can be immobilised by the application of a vesicant or 
mild blister. A week or ten days later dry friction, muscular and peri- 
articular massage are indicated, and gentle exercise should be commenced. 
The same treatment may be employed in strain of the elbow joint and 
in strains of muscles or tendons in the neighbourhood of joints. Such 
lesions are, however, very rare in the ox. 

STRAIN OF THE KNEE. 

Strain of the knee is commoner in the ox than in the horse, because of 
the special conformation of the knee in the ox and the mode of working 
under a yoke. This mode of working gives less individual liberty to the 
fore quarters, and sometimes interferes with the animal's efforts when 
moving a load. Strains of ligaments and periarticular injuries occur as 
a general rule on the inner side of the limb. 

The symptoms consist in lameness, exaggerated sensibility on pressure, 
pain on forced flexion of the knee, and swelling of the entire periarticular 
region. 

The prognosis is somewhat serious in working oxen. 



54 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

Treatment, when applicable, should consist of stimulant dressings, 
massage, and douches. 

STRAIN OF THE FETLOCK. 

This is one of the commonest accidents of draught oxen. 

Causation. Working on rough, irregular, rocky ground, or on roads 
with deep ruts, is the commonest cause of this condition. When the 
animal moves on irregular surfaces the two claws do not bear an equal 
share of weight ; sometimes the whole weight is for a moment thrown 
on one claw. 

The phalanges, therefore, are displaced inwards or outwards, or are 
twisted around their vertical axis, causing the fetlock joint and its sup- 
porting ligaments to be more or less severely strained. The internal or 
external ligaments of the joint or the suspensory ligament or flexor 
tendons may even be lacerated. 

The fetlock may also be strained by the animal making violent efforts 
to free the claws or pastern which have become fixed in a hole in the 
ground, in bogging, in hobbling, or in leaping a fence. 

Symptoms. Lameness is noticeable from the beginning, but is 
unaccompanied by any visible lesion. On examination of the limb, the 
entire region from the fetlock downwards is found to be sensitive to 
pressure, and painful when forcibly extended or flexed from side to 
side. This sensitiveness is particularly marked when the phalanges are 
rotated on the shank. A few days later the entire fetlock becomes the 
seat of diffused swelling. 

Diagnosis is facilitated by the fact that the fetlock has an entirely 
different appearance from that seen when tendon sheaths or the synovial 
capsules of joints are distended. • 

Prognosis. The prognosis varies considerably, according to the extent 
to which deep-seated structures are involved, and the gravity of the 
lesions is usually proportioned to the intensity of the symptoms. 

Treatment. Frequent cold applications, cold foot baths for an hour 
or two night and morning, and even cold poultices are useful. AVhen 
the pain has somewhat diminished, which usually occurs in from three 
to four days, vesicants may be employed, and, at a later stage, massage. 
Failing improvement by these methods, the injured region may be fired 
in points. 

Strain of the hind fetlock occurs under precisely similar conditions to 
those above described in the case of front limbs. 

STRAIN OF THE STIFLE JOINT. 

Strain of the stifle joint results from over-extension of ligaments 
without displacement of the patella, and also (and probably more 



STRAIN OF THE HOCK JOINT. 55 

frequently) from injuries to the aponeurosis and tendons of insertion of 
the abductor muscles of the femur and tibia. 

Causation. Strain of the stifle may follow violent collisions, such as 
occur in entering or leaving the stable, from falls on rough ground, from 
direct blows, from slips, etc., or even from the sudden and violent 
contraction of the muscles of the antero-external surface of the quarter. 

Symptoms. Lameness follows immediately or soon after the accident, 
and is of a peculiar character ; to avoid using the injured joint, the 
animal advances the hind limb with a mowing movement. 

The injured region exhibits diffuse inflammatory swelling, which 
impedes palpation, and makes it difficult to determine the exact nature 
of the local lesion. The thigh at the stifle is painful. 

Diagnosis and prognosis. Diagnosis presents no considerable diffi- 
culty. The prognosis must be based on the intensity of the symptoms, 
and becomes grave if the tendons or aponeurotic insertions be injured, 
or extensive damage have been done to ligaments. 

Treatment. At first, continued cold applications, douches, and 
massage are most useful ; blisters are more effective in the grave cases, 
and comprise not only the ordinary blisters, but the powerful mixed 
blister containing tartar emetic, powdered hellebore, bichromate of 
potash, etc. If for any special reason it is of importance to preserve 
the animal's life, the parts may be fired ; but for economic reasons it 
is usually better to fatten it for the butcher. 



STRAIN OF THE HOCK JOINT. 

Causation. Strain of the hock joint is commonest in young oxen 
which are being trained to work. Their hind quarters are necessarily 
more or less free, and the animals are apt to make side movements to 
avoid the goad, thus exposing the hock to irregular strain. 

The internal ligaments are more frequently strained than the external, 
a fact due to the conformation of the hocks. 

Symptoms. Strain is accompanied by lameness, most marked when 
the animals endeavour to turn, by exaggerated sensibility of the entire 
hock region, and, in grave cases, by subcutaneous oedema. 

Diagnosis and prognosis. Diagnosis is simple. The prognosis is 
sometimes grave, because a spavin or a permanent chronic enlargement 
of the capsule of the true hock joint may form. 

Treatment. It is often desirable at once to apply an extensive 
blister over the whole hock and to supplement this at a later stage by 
cold applications, or by continuous cold irrigation for half an hour or 
more both night and morning. 

In exceptional cases the use of the actual cautery becomes necessary. 



- 56 DISEASES OF THE SYNOVIAL MEMBRANES AND AKTICULATIONS. 

III.— LUXATION OF JOINTS. 

Luxation consists of permanent displacement of the bony surfaces 
forming a joint, and may follow violent mechanical injury or any 
other cause. 

Luxations have been divided into congenital, i.e., such as exist from 
the time of birth; spontaneous, i.e., those which result from some defect 
of conformation or constitution ; and acquired or accidental, which occur 
as results of falls, wounds, accidents, etc. 

From the point of view of their duration, luxations are termed 
temporary when they do not necessitate reduction, progressive when 
the tendency is towards greater and greater displacement of the surfaces, 
or permanent when reduction is impossible. 

Those commonest in bovines are luxations of the femur, luxation of 
the patella, femoro-tibial luxation, and luxation of the scaj)ulo-humeral 
joint. 

LUXATION OF THE FEMUR. 

Luxation of the head of the femur with displacement beyond the 
cotyloid cavity is very frequently congenital. The condition also occurs 
with some frequency in adults or aged animals in consequence of 
relaxation of the articular ligaments and the absence of the subpubic 
ligament (pubio-femoral ligament). 

Causation. Luxation may be congenital, the head of the femur 
being displaced backwards and carried above the cotyloid cavity. This 
form is of no practical interest, because the animals are not usually 
reared. More frequently in young or adult animals it assumes the 
spontaneous progressive form, in consequence of degenerative changes in 
and relaxation of the coxo-femoral interosseous ligament. The head of 
the femur presses on the upper margin of the cotyloid cavity, which it 
injures, and eventually becomes lodged in the neighbourhood of the neck 
of the ihum, in the great sciatic notch. 

This luxation is also found as a purely accidental occurrence in 
animals which have suffered from falls and from slipping of the hind 
limbs backwards or sidewards, as occasionally follows awkward leaping 
movements. The slipping outwards of the limbs, which causes this form 
of luxation, is comparatively easy, because of the absence of the pubio- 
femoral ligament. The accident may also be followed merely by 
subluxation, that is to say, tearing of the inner portion of the capsular 
ligament and rupture of some portion of the adductor muscles of the 
thigh without rupture of the interosseous fibres, the head of the femur 
not quitting the cotyloid cavity. This accident occurs in stables with 
smooth, slippery floors, and in railway trucks. It may affect one side 
or both. The latter condition is exceptional. 



LUXATION OF THE FEMUE. 



Finally, luxation may be either complete (in which case the capsular 
and interosseous ligaments are both ruptured) or incomplete. In the 
former case, the head of the femur becomes dis23laced upwards and 
forwards towards the great sciatic notch, more rarely backwards in the 
direction of the ischium, and in exceptional cases downwards and 
inwards below the pubis into the foramen ovale. 

Symptoms. The symptoms vary, depending on whether the luxation 
is of the spontaneous, progressive order or, on the contrar}^, is accidental. 
In progressive luxation, the animals are able to rise and walk with 
difficulty. The affected limb swings when the animal is advancing, not 
as though it were paralysed, but simply as though displaced at its upper 



w-^- 



fe^ 




Fig. 21. — Accidental luxation of the hip joint. 

part. Pain is exhibited when weight is placed on the limb, and there is 
difficulty in movement. The limb appears shorter than its neighbour 
when the animal stands on it, and the prominence representing the 
trochanter is more marked. When a false joint has formed, the limb is 
rigid, is moved stiffly and abducted, and the stride is shortened. 

In accidental luxations, either of one or both limbs, the attitude 
assumed by the animal is often characteristic. One of the limbs is ex- 
tended at right angles to the longitudinal axis of the body, and some- 
times both limbs assume this position, an attitude which would be 
absolutely impossible under normal conditions. The animal cannot 
rise. It lifts the front part of the body by rising on its knees, but the 
hind quarters do not follow. The ruptured adductor muscles are unable 
to bring and hold the limb parallel to the longitudinal axis of the body ; 
the abductors act unopposed, and at the moment wdien the animal makes 



58 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

its greatest effort to rise the limb (or limbs) is carried outwards and the 
body comes to the gromid on the udder or groin. 

Inspection discovers a depression where the great trochanter should 
be. On applying the open hand over the hip joint, whilst an assistant 
who grasps the pastern moves the limb in different directions, one can 
feel and hear, in spite of the mass of muscle covering the part, a modified 
crepitation due to sero-sanguinolent effusion in and around the joint. 
This crepitation can also be detected by pushing the hand as high up as 
possible on the internal surface of the thigh, and thus exploring the 
neighbourhood of the luxation. 

Diagnosis- The position which the animal assumes when one 
endeavours to make it rise is characteristic. Diagnosis of progressive 
luxation, however, is more difficult. 

Prognosis. The prognosis is extremely grave ; for, even though 
reduction can be effected, one is practically unable to ensure that the 
parts shall remain in position. 

Treatment. Treatment comprises reduction of the luxation and 
fixation of the parts. Keduction can be effected without very much 
difficulty by casting the animal on the affected side, placing a block 
of wood, or a pail, between the thighs, and manoeuvring the limb 
in the desired direction. As, however, subluxation is the condition 
most commonly seen, there is frequently no reduction to effect. More- 
over, fixation of the joint after reduction is almost impossible in such 
heavy subjects, and luxation is very liable to recur. From an economic 
standpoint, slaughter is advisable or imperative. 

LUXATION OF THE PATELLA. 

Luxation of the patella is not uncommon in working oxen, and is 
occasionally seen in cows as the result of a slip when entering or leaving 
the byre, the reason being the peculiar anatomical arrangement of the 
femoro-patellar articulation. 

The internal lip of the trochlea of the femur is very high, the external, 
on the other hand, being only slightly developed. The patella itself is 
smal'.er than that of the horse, and possesses a small cartilaginous 
prolongation, principally on its inner face, in marked contrast with the 
large cartilage found in the horse. As in the latter animal, the out- 
ward displacement of the patella is only prevented by the internal patellar 
ligament and the femoro-patellar aponeurosis. Under the influence of 
varying causes to which the joint is exposed, these supporting structures 
often prove insufficient to prevent the patella being displaced outwardly. 

Causation. From an anatomical standpoint, luxation inwards seems 
impossible. It certainly must be very rare and be preceded by rupture 
of the external ligament. On the other hand, as in the horse, it seems 



LUXATION OF THE PATELLA. 59 

130ssible that the patella may be caught on the summit of the mternal lip 
of the trochlea, especially if the trochlea happens to present a flattening 
at that point. 

Outward luxation may be spontaneous or accidental. It is termed 
spontaneous, when produced by relaxation of the ligaments of attachment 
or by irregular muscular action; accidental, when resulting directly from 
any external mechanical cause. Violent contraction of the triceps cruralis, 
by lifting the patella beyond its normal limit of travel, helps, or at least 
permits, the patella to be displaced outwardly at the moment when the 
muscle relaxes. 

Pathological relaxation of the ligaments and muscles, by allowing the 
patella to descend too far on the trochlea, also renders displacement 
possible, hence spontaneous luxation sometimes occurs even w^hile the 
animal is at rest in the stable. This luxation is certainly only of a 
temporary character, or perhaps only of the nature of subluxation, and 
is often reduced by mere muscular contraction when the animals are 
forced to move. 

Should the hind limb slip in a backward direction the angle of the 
joint becomes more obtuse and the lips of the trochlea are turned down- 
wards, thus greatly favouring lateral displacement of the patella, which 
under these circumstances is no longer immobilised on the trochlear 
pulley ; displacement outwards then occurs, constituting the condition 
termed luxation. 

Various forms of mechanical violence, like blows, collisions of the stifle 
with the jambs of doors, falls, etc., may also bring about this luxation. 

The symptoms of fully-developed accidental luxation are charac- 
teristic. Immediately the accident occurs, the limb is immobilised in a 
state of complete extension ; neither the stifle nor the hock joint can be 
flexed, and only the fetlock joint retains any degree of mobility. 

Movement is very difflcult. The hind limb appears rigid, as though 
formed of one bone. The pastern is directed backwards and dragged 
along the ground, and when weight is placed on the limb the anterior 
surface of the pastern may almost be in touch with the ground. The 
limb is advanced, but the foot cannot be placed properly on the ground. 

Locally the patella is found to be outside the external lip of the 
trochlea, and its internal ligaments are extremely tense. 

If the luxation is spontaneous and of muscular origin, or a consequence 
of relaxation of the tendons, it is usually noticeable immediately the 
animal leaves the stall. The animal cannot move without great difficulty. 
It grows steadily ,worse with the lapse of time, because the synovial mem- 
brane becomes irritated and chronic arthritis is set up. 

The symptoms are identical with those of traumatic luxation, but are 
only temporary. 



60 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

Diagnosis. The position of the Hmb and the displacement of the 
patella are sufficiently distinctive to render diagnosis fairly easy, and to 
allow of this accident being differentiated from luxation of the femoro- 
tibial joint or hooking of the patella in the ischio-tibial muscle. 

Prognosis. The prognosis varies greatly. If the luxation is of 
traumatic origin and the accompanying symptoms are not grave, reduc- 
tion may be followed by permanent recovery. On the other hand, in 
spontaneous luxation recurrence is almost inevitable. 

Treatment. The indications for treatment may be comprised in a 
single phrase : reduction, with immobilisation of the parts for a suffi- 
cient time. To effect reduction, a strip of webbing is fixed around the 
pastern of the affected limb, passed over the withers, in front of the 
shoulder of the opposite side, and brought round in front of the neck or 
between the front limbs. By means of this an assistant exercises strong 
traction on the limb until the fetlock is raised as high as the elbow of the 
same side. The operator then applies strong inward pressure to the 



Fig. 22. — Bandage for luxation of the patella. 

patella, which usually slips back on to the gliding surface of the trochlea 
at the first or second effort. 

After-treatment comprises the application of a smart blister, produc- 
ing cedematous infiltration of all the tissues around the joint, and thus 
impeding movement and recurrence of luxation. For this purpose various 
preparations are used — e.g., cantharides, biniodide of mercury, croton 
oil, etc. It is also advisable to fix the animal so that for a time it cannot 
lie down, and to secure the pastern to the neck by means of a side-line. 

As an experiment, cases of simple fixation of the patella on the summit 
of the internal lip of the trochlea might be treated by Bassi's method — 
i.e., subcutaneous division of the internal lateral ligament of the patella 
which holds the bone in its abnormal position. 

Finally, in spontaneous luxation, occurring in young animals in which 
bhsters have been ineffectually tried after reduction, Benard's bandage 
may be used, though it is not generally regarded as very practical. It 
consists of a piece of cloth of elongated lozenge form about four feet 
in length, six inches in breadth at its centre and two inches at its ends. 
Its centre is pierced by a transverse opening intended to surround 
the patella, and carries a loop for the purpose of supporting the turns of 
bandage. A second longitudinal opening is situated about eight inches 
from the centre. 



LUXATION OF THE FEMORO-TIBIAL ARTICULATION. 61 

Eecluction being effected, the whole region of the stifle joint is covered 
with Burgundy or ordinary pitch and the bandage then appKed. The 
patella jDrojects through the central opening. The end A is passed 
backwards around the thigh, and through the aperture B ; the two cross 
ends are then brought forward, crossed again at the end, the loop over 
the patella carried a second time backwards, again crossed, and finally 
fixed in front under the patella. The bandage should be fi-rmly applied, 
without, how^ever, being so tight as to interfere with circulation, and must 
be left in place from eight to ten days. 

Van Denmoegdenberg recommends placing the patient on an inclined 
plane, with the hind quarters a foot higher than the front, so as to cause 
permanent contraction of the anterior muscles of the quarter, and thus 



^_- 





Fig. 23. — Backward luxation of the femoro -tibial joint. (From a photograph 
by Professor Besnoit.) 

immobilise the patella. Simple cold baths, frequently repeated, friction 
with camphorated alcohol or essence of turpentine, complete this original 
but somewhat questionable treatment, and are said to result in recovery 
in a fortnight. 

LUXATION OF THE FEMORO-TIBIAL ARTICULATION. 

This form of luxation is rare, a fact explained by the strength of the 
lateral ligaments of the joint, and of the cruciform interosseus ligaments. 
It may assume different forms, according as the head of the tibia is dis- 
placed in front of, behind, to the inside, or to the outside of the lower 
extremity of the femur. In all, therefore, it may appear in four different 
forms. The commonest is backward luxation. 



62 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 



Causation. With the sole exception of luxations or subluxations 
due to tuberculosis (lateral luxations, either inwardly or outwardly, 
occurring during tubercular arthritis, with more or less marked destruction 
of the condyles), these luxations are always accidental or the result of 
mechanical violence. 

They result from leaping into hollows, falling into deep ditches or 
ravines, or galloping through broken or steep places. Any violent shock 
affecting the femur, either in front or from the outside, is capable of 
causing luxation backwards or inw^ards. 

Symptoms. The most frequent condition is backward luxation of the 
upper extremity of the tibia. Movement becomes difficult, the limb 

is held rigidly, and all the lower part of the 
leg is extended. None of the joints can be 
flexed. The leg is dragged forward, without 
the animal being able to place the foot flat on 
the ground, and the claws are trailed over the 
litter or the toe grazes the soil. 

On local examination the stifle is seen to be 
deformed. The lower extremity of the femur 
and the patella appear prominent. The upper 
part of the tibia is thrust backwards, and seems 
to have disappeared, leaving a depression below 
the femoro-patellar region. The muscles form- 
^^ ing the back of the thigh at this level are 
thrust out of position, and appear to project 
abnormally. 

Viewed from behind, the inner line of the 
thigh appears more or less convex when the 
upper extremity of the tibia is luxated inwardly. 
On local examination the displacement of the 
bones can be readily detected. In luxation 
forwards the prominence of the stifle is caused by the summit of the 
tibial crest and by the patella, whilst the lower extremity of the femur 
cannot be felt. In outward luxation the upper extremity of the tibia 
forms an abnormal prominence, above which a horizontal digital 
depression appears. 

Diagnosis. Provided that the examination is made soon after the 
occurrence of the accident, little difficulty will be found in coming to a 
conclusion, but the diagnosis necessitates more care when examination is 
deferred for two or three days, because extensive effusion then exists. 
Luxations or subluxations of tuberculous origin are generally consecutive 
to old- standing destructive tuberculous arthritis. 

The prognosis is grave — firstly, because reduction is difficult; and, 







Fig. 24. — Luxation back- 
wards and inwards of the 
femoro-tibial joint. (From 
a photograph by Professor 
Besnoit.) 



LUXATION OF THE SCAPULO-HUMERAL JOINT. 63 

secondly, because it is often impossible to maintain the reduction and to 
preserve complete immobilisation of the injured joint. 

Treatment should not be undertaken except in j-^oung animals ^vhich 
have not yet attained full development. 

In attempting to reduce outward or inward luxation of the tibia the 
animal should be cast on the side opposite to the lesion. Counter- 
extension is practised by passing a length of webbing around the limb in 
the region of the groin ; extension in the direction of the length of the 
femur by means of a loop of webbing fixed to the cannon bone : the 
operator uses both hands in endeavouring to replace the head of 
the tibia. 

In forward luxation of the tibia counter- extension is effected by 
means of a loop of webbing passed above the hock and drawn forward. 
Extension is made backwards in an oblique direction, the operator again 
being left free to effect reduction with both hands. 

Reduction of backward luxation of the tibia is still more difficult, in 
consequence of the contraction of the mass of muscle at the back of 
the thigh. 

Plaster bandages are the most convenient means of immobilising the 
parts after reduction. 

LUXATION OF THE SCAPULO-HUMERAL JOINT. 

This luxation, like that of the femoro-tibial articulation, is exceptional. 
It may assume one of two forms, depending on whether the head of the 
humerus is displaced inwardly, or towards the back of the glenoid cavity ; 
but as a rule luxation occurs inwardly. Forward luxation of the head 
of the humerus is almost impossible, in consequence of the resistance 
offered by the tendons of the flexor brachii and antea spinatus muscles. 
Similarly, luxation outwards is very difficult, the tendon of the postea 
spinatus being very powerful and offering enormous resistance. 

Inwardly, on the other hand, the insertion of the subscapularis is 
much less powerful, and there is no real opposition to movement of the 
head of the humerus. 

Causation. Violent mechanical shocks transverse to the upper third 
of the arm may, by sheer force, displace the head of the humerus in an 
inward direction, causing rupture of the internal wall of the capsular 
ligament and of the subscapularis muscle. Jumping from high to low 
ground and falling on the front limbs tend to displace the glenoid cavity 
in front of the head of the humerus, and often result in luxation of the 
bone in a backward direction, a luxation, however, which almost always 
assumes a postero-internal direction. The commonest causes of these 
luxations are the sideward falls of animals which have attempted to 



64 DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 

cover others. Whether the subject be a bull or a cow, if the stationary 
animal suddenly moves to one side, or if the moving animal is frightened 
by the appearance of a dog, one of the front limbs may be violently 
dragged away from the body ; the resistance of the cajjsular ligament 
and internal muscles of the shoulder may be overcome and luxation 
produced. 

Symptoms. Symptoms are immediately apparent : no weight can be 
placed on the injured limb, and the animal moves on three legs. All 
muscular action is avoided, the limb is slightly shortened as a conse- 
quence of the head of the humerus slipping behind the shoulder, which 
is held rigidly during movement ; the points of the claws are dragged 
along the ground. 

On local examination the point of the shoulder appears to be deformed 
and outwardly displaced, in consequence of the pressure exercised by the 
displaced head of the humerus. Below the glenoid cavity and coracoid 
process lies a depression, at the base of which the displaced humerus 
can be felt. This depression, however, is soon filled up by the sero- 
sanguinolent effusion consequent on luxation. 

Diagnosis. Bearing in mind the conditions to which the accident is 
due, the diagnosis presents no great difficulty. 

Prognosis. The prognosis is grave, for although it is relatively easy 
to reduce the displacement, it is very difficult to keep the joint fixed 
in position. 

Treatment. To effect reduction, the animal should be cast on the 
sound side, and a loop of webbing passed under the arm, in order to 
provide for counter-extension. The limb is extended by direct traction 
on the cannon bone or fetlock, whilst the operator endeavours to effect 
reduction with one hand placed in front and one behind the joint. 

In young animals of trifling weight immobilisation may be attempted, 
the best method being the application of pitch plasters. If, on the other 
hand, the subject is heavy, there is so great a chance of displacement 
when lying down and rising, that such cases are usually sent to the 
butcher, or abandoned to chance. Eelative recovery, sufficient to permit 
of growth or fattening, may take place without professional assistance. 

IV.— HYGEOMAS. 

Hygromas result from chronic inflammation of serous bursse, naturally 
existing, or of serous bursse which form at prominent points where the 
skin is exposed to repeated friction, blows, shocks, or over-extension. 

They usually develop slowly, without producing marked pain or 
alarming symptoms, and therefore the practitioner is seldom consulted 
until the swelling has attained a considerable size. 



HYGROMA OF THE KNEE. 



65 



discharging pus. 
thickened 



fibro-cartilaginous 



The h3^groma is usually characterised by its non-painful character 
and by regular fluctuation throughout. The walls of the serous bursse 
are merely thickened, so that palpation is easy. 

Should the hygroma become infected and inflamed, it assumes the 
same characters as an abscess : it becomes highly sensitive, is surrounded 
by oedematous infiltration, shows more marked fluctuation at some 
specialised point, and eventually breaks, 

Long-standing hygromas often have 
and extremely hard walls, which render 
examination more difficult. 

Where the hygroma is much exposed 
to friction the skin covering it undergoes 
complete transformation, the layers of 
epidermis becoming converted into a 
substance resembling horn. The entire 
substance of the wall of the hygroma then 
undergoes change, and is often infiltrated 
with lime salts or encrusted with plates of 
bone of varying thickness. 

HYGROMA OF THE KNEE. 

This condition is very common in 
bovines, a fact explained by the manner 
in which these animals rise. Whilst the 
hind limbs are being lifted, the entire 
burden of the body weight is transmitted 
to the knees and the tissues covering them ; 
so that, if the ground is rough, the skin may 
be sufficiently displaced to produce lacera- 
tion of the subcutaneous connective tissue, 
serous effusion in the layers of connective 
tissue, and the immediate production of 

an hygroma beneath the skin and in front of the synovial sheaths of 
the extensor tendons. 

Hygroma is principally caused by falls on the knees, roughness of the 
stable floor, prolonged decubitus during the course of a serious disease, 
or after an attack of foot-and-mouth disease. 

Hygromas may be no larger than a turkey's egg or a man's clenched 
fist, but sometimes assume the dimensions of a child's head. Calcifica- 
tion and ossification of the walls and cornification of the skin are 
commonest in old hygromas of the knee. 

The sensibility and uniform fluctuation make mistakes in diagnosis 

D.C. F 




Fig. 25. — Old-standing hygroma 
of the knee. PE, external coat ; 
CC, cornified coat ; CO, osseous 
coat ; CP, pus cavity ; PI, internal 
coat. 



66 DISEASES OF THE SYNOVIAL MEMBRANES AND AIITICULATIONS. 



difficult. The condition can only be confused with distension of the 
synovial sheath of the extensor metacarpi magnus ; but this (synovial) 
swelling extends in the same direction as the tendon, i.e., vertically, 
attains the lower third of the radius, and is broadest above. Hygromas 
must also be distinguished from tumours. Moussu only mentions a 
single case of this kind, the tumour being very slightly bosselated and, 
naturally, revealing no fluctuation. 

The prognosis is not grave, though the condition may prove trouble- 
some, because the original injuries may be continued even during treat- 
ment and prevent recovery. 

Treatment. Success rarely follows 
cold applications or blistering, which 
are only of value at the commence- 
ment. It is better to puncture the 
cavity aseptically, remove the fluid 
contents, and fire the growth in points. 
Free opening of the lowest portion of 
the swelling is followed by discharge 
of liquid, but almost inevitably by in- 
fection at a later stage, and by suppu- 
ration. Kecovery certainly may occur, 
a slight thickening of the anterior 
surface of the knee remaining ; but 
the process is often very prolonged. 
Some authors prefer to pass a seton or 
drain vertically through the swelling. 
The results are identical wath those 
following free opening and drainage, 
suppuration being unavoidable. 

If the animal be sufficiently valu- 
able to warrant surgical intervention, 
the entire hygroma, together with its 
indurated wall, may be excised. An 
elliptical fragment of skin is removed from the front of the swelling, and 
the whole mass separated by dissecting away or tearing through the connec- 
tive tissue. Considerable care is necessary to avoid injuring the synovial 
sheaths of the -extensor tendons. This treatment, which is only applicable 
in valuable animals, is comjDleted by firmly suturing the lips of the wound, 
and applying an antiseptic surgical dressing or a plaster bandage similar 
to that used in operating on broken Imees in horses.* The animal must 
be prevented from lying down until the wound has firmly united. 

* See Dollar's "A Surgical Operating Table for the Horse." (London: Gay 
and Bird.) . 




Fig. 26.^ — Hj^groma of the knee. The 
skin has undergone conversion into 
a substance resembling horn. 



HYGROMA OF THE STIFLE* 67 

HYGROMA OF THE HAUNCH. 

With the exception of hygroma of the knee, hygromas are commonei' 
on hind than on front hmbs. That of the haunch is Umited to the 
external angle of the ilium. It follows violent falls or collisions with 
door posts, and results from laceration of the layers of subcutaneous 
connective tissue and separation of the skin from subjacent parts. 

The effusion is often of a sero-sanguinolent character. It is more 
frequent in animals occupying narrow or irregularly shaped stalls, the 
hygroma being developed through repeated collision o£ the angle of the 
haunch with the wall. Finally, it may follow prolonged decubitus. 

Diagnosis is easy, but the prognosis has a certain element of gravity, 
because, should suppuration occur, it may be succeeded by necrosis of 
the aponeurosis inserted into the external angle of the ilium. 

Treatment should first be directed to removing the cause. Of the 
various modes of intervention, the best probably consists in disinfecting 
the parts, j^micturing the swelling, and injecting some irritant of an 
antiseptic character, or simply washing out the cavity. Iodine and 
carbolic solutions are most commonly employed. Firing is contra- 
indicated. 

HYGROMA OF THE TROCHANTER OF THE FEMUR. 

This condition is rare, except in thin milch cows kept under bad 
hygienic conditions and insufficiently supplied with bedding. Continual 
bruising of the prominences of the quarters whilst the animal is lying 
is the usual cause. 

This hygroma forms a hemispherical swelling covering the trochanteric 
prominence. Movement is interfered with, and the stride is shortened. 

The condition can only be confused with the diffuse swellings due to 
periarthritis in the coxo-femoral region, which frequently occur in cows 
suffering from infectious pseudo-rheumatism. 

The prognosis is somewhat grave, for in case of suppuration the 
insertions of tendons and fascia into the summit of the trochanter may 
become necrotic. 

Treatment. The first point is to supply the animal with ample clean 
bedding. The swelling may be repeatedly blistered. If considered neces- 
sary, a puncture may be made under antiseptic precautions, the fluid drawn 
off, and the cavity washed out ; but it is better to avoid opening the parts 
with a bistoury, on account of the danger of suppuration and of necrosis 
of the tendons and aponeurotic tissues in the neighbourhood. 

HYGROMA OF THE STIFLE, 

Hygroma of the stifle or of the patella appears under the skin, outside 
the external ligament of the femoro-tibial articulation. It usually follows 



08 



DISEASES OF THE SYNOVIAL MEMBRANES AND ARTICULATIONS. 



repeated abrasion when lying down, especially if the paving of the stalls 
is rough or irregular. 

The swelling varies in size from a hen's egg up to that of a child's 
head, and exhibits fluctuation throughout. 

The prognosis is somewhat serious, for 
here again complications may result from 
necrosis of neighbouring aponeuroses. 

Some authors recommend passing a seton 
dressed with some irritant material through the 
swelling. Aseptic puncture, however, seems 
preferable, followed by washing out of the 
cavity and the application of a blister. 

HYGROMA OF THE POINT OF THE 
HOCK. 




This hygroma usually results from blows 
with the ox-goad, which cause inflammation 
of the subcutaneous connective tissue and 
cedematous infiltration extending down the leg. Afterwards the slightest 



Fig. 27.— Capped hock. 




Fig. 28. — Hygroma of the pomt of the sternum. 

injury, or even the friction due to the animal lying down, causes liquid 
to collect and an hygroma to form. 

This hygroma is readily infected and often suppurates ; it then 
becomes very sensitive, producing intense lameness. More frequently, 
however, under the influence of prompt treatment, the liquid is 



HYGROMA ^OF THE POINT OF THE STERXUM. 69 

absorbed, the layers of siibcntaneoiis connective tissue become hardened, 
and undergo more or less extensive induration. 

HYGROMA OF THE POINT OF THE STERNUM. 

Hygroma of the point of the sternum is a vmij. It only occurs 
in thin animals in which the point of the sternum is prominent, and 
which are confined to stables ^Yith rough floors and pro^ided with 
insufficient bedding. 

The swelling should not be opened, for the tissues in front of the 
sternum readily become the seat of suppuration. 

If treatment is desirable, the fluid may be drained oft' by means of an 
aseptic puncture. 



CHAPTER IV. 

DISEASES OF MUSCLES AND TENDONS. 

RUPTURE OF THE EXTERNAL ISCHIO^TIBIAL MUSCLE 
(BICEPS FEMORIS), 

The biceps femoris muscle extends from the superior spinous process 
of the sacrum to the region of the patella and the external surface of 
the thigh. Above, it is inserted into the sacrum and the posterior 
margin of the ischium, below into the supero- external surface of the tibia. 
It completely covers the coxo-femoral articulation, and its passage over 
the summit of the trochanter is lubricated by a serous bursa. The whole 
of its anterior margin is connected with the fascia lata by an aponeurotic 
expansion. From varying causes this aponeurotic layer may become 
fissured ; during the backward and forward movements of the limb the 
summit of the trochanter may enter the fissure and become fixed there 
by the tension and resistance of neighbouring tissues. This accident 
has been described as " displacement or rupture of the biceps femoris 
muscle." 

According to Cruzel, fixation of the biceps femoris may occur, in very 
thin animals, without rupture of the musculo-aponeurotic layer, the 
process being then simply confined to stretching of the aponeurotic layer 
over the summit of the trochanter. Under such circumstances the 
musculo-aponeurotic layer presents a cup-like depression, into which the 
summit of the trochanter fits, and thus effectually prevents movement of 
the muscle. 

Whether the accident is due to an actual fissure, or only to stretching 
of the aponeurosis, the symptoms are the same. 

Causes. The principal predisposing causes are thin condition and 
malformation of the limbs (turning outward of the hind toes). 

The accident may occasionally be caused by a slip backwards, or by 
extreme efforts in draught when ascending hills. 

Symptoms. Immediately the accident occurs the limb becomes fixed 
in a position of maximal extension. The trochanter being caught, the 
femur can no longer be flexed, and the lower joints are also fixed in 
such a way that the limb can only be moved as a whole. The claws 



RUPTL^KE OF THE EXTERNAL ISCHIO-TIBIAL MUSCLE (BISCEPS FEMORLS). 71 

are dragged along the ground, and the affected Hmb, which can never be 
completely advanced, is brought forward with a mowing movement. 

On local examination, the trochanter appears to be very prominent, 
and situated directly above a rigid cord which extends parallel with 
the anterior margin of the affected muscle. 

If the accident consists merely in the formation of a depression in 
the muscle, in which the summit of the trochanter is fixed, and if there 
is no Assuring, the muscle and the femur are certainly immobilised, but 



1— IH 




Fig. 29. — i^rrangement of the external ischio -tibialis muscle. 1, Anterior 
margin of the muscle ; 2, fascia lata. 

the limb can be moved to a certain extent, the " mowing " movement is 
less marked, and there is no well-defined rigid cord along the anterior 
margin of the muscle. 

Diagnosis. The condition can only be confused with luxation of the 
patella ; but manual examination of the affected parts revealing the 
presence of a rigid cord below the trochanter at once removes any 
doubt. 

Prognosis. The prognosis is only grave in working animals. More- 
over, the accident is now^ much rarer than formerly, if only because 
animals are better looked after and better fed. 

Treatment. If the accident results simply from the formation of a 
depression in the musculo-aponeurotic layer which replacesthe muscle 



72 DISEASES OF MUSCLES AND TENDONS. 

at the point Avhere it passes over the trochanter, there is nothing to be 
done. Eeduction will occur spontaneously, and entire liberty of action 
will be regained. Cruzel states that it is sometimes sufficient to force 
the animal to move down a slope, in order to withdraw the trochanter 
from the depression in which it has been lodged, and to restore its 
normal mobility. 

Eest and good feeding favour the deposition of fat, and soon alter 
the conditions responsible for the accident ; the muscles of the quarter 
become surrounded with fat, the external ischio-tibial muscle (biceps 
femoris) is thrust outw^ards on account of its superficial position, and 
then cannot be ruptured by the summit of the trochanter. If, on the 
other hand, the musculo-aponeurotic layer is fissured and the summit of 
the trochanter firmly fixed in the opening, operation becomes necessary. 
This consists in incising the anterior margin of the muscle over the 
afore-mentioned rigid cord. The margins of the wound retract, the 
tension of the cord is diminished, the trochanter released, and the 
normal play of the limb restored. 

Numerous methods of operation have been described and a number 
of special instruments invented. The earlier methods consisted in simple 
subcutaneous section of the rigid cord formed by the musculo-aponeurotic 
layer and the muscle. Subcutaneous section is carried out exactly like 
tenotomy, using straight and curved tenotomes. The seat of operation 
is about three inches below the summit of the trochanter. In the 
absence of tenotomes, section may be performed with a bistoury intro- 
duced from below the muscle by means of a grooved director, which has 
been inserted through a cutaneous puncture made at the point indicated 
over the anterior margin of the promiiient cord. 

In better nourished subjects, in which this cord is less prominent, 
the operator may, to ensure greater accuracy, make a vertical incision 
an inch or two in length at the point selected over the anterior margin 
of the muscle, isolate this muscle by means of the director, and after- 
wards perform the section. Considerable ha3morrhage occasionally 
follows division of some small muscular vessel, but is of no consequence 
unless the wound has been infected. 

RUPTURE OF THE FLEXOR METATARSI. 

The rupture of this tendon-muscle is exceptional, and, according to the 
description given by Furlanetto, is attended by the same symptoms as in 
the horse — i.e., flexion of the stifle joint is not accompanied by flexion of 
the hock or of the metatarsus on the tibia. The cannon-bone hangs 
vertically when the limb is moved. 

Becovery follows prolonged rest. 



CYSTICERCUS DISEASE OF THE PIG. 



73 



Wounds and sections of tendons in the region of the cannon bone, 
sections of the tendo-AchilHs, etc., have been seen and described. All 
such injuries may heal under antiseptic treatment and after aseptic 
suture of the divided ends, provided the sutures and dressings are applied 
immediately. If, on the other hand, suppuration, infection, necrosis 
of tendons, synovitis or arthritis occur as complications, such injuries 
become extremely serious, and from an economic standpoint render it 
better to sacrifice the animal rather than attempt treatment. 

Strains of tendons and tendinitis occur in the front limbs of oxen, 
particularly of those used in carts. The chief indications are swelling in 
the region of the cannon bone and fetlock, uneven contour of the flexor 
tendons, sensibility on pressure, and lameness of varying intensity. 

Treatment consists in continuous cold irrigation, massage, the 
application of a blister or even of the actual cautery. As a rule, how- 
ever, it is better to rest and fatten the animal. 

A frequent complication of such injuries of tendons consists in 
knuckling over at the fetlock. 

PARASITIC DISEASES OF MUSCLES. 

INFECTION WITH CYSTICERCI. 

Infection of the connective and muscular tissues with cysticerci 
results from the entry into the body of embryos of Tcenia solium and 
Tcenia saginata of man. It occurs in man and almost all animals, but 
is only of grave clinical importance in the pig and ox. 

The following table shows the chief cystic (cestode) parasites of animals, 
though the cysts are not always confined to muscular structures : — 



Adult. 


Larva. 


Name. 


Host. 


Nam p. 


Host. 


Tcenia saginata 
Tcenia solium . . 
Tcenia niarginata . 
Tcenia coenurus 
Tcenia echinococcus 


Man 
Man 
Dogs 
Dogs 
Dogs 


Cijsticercus bovis . . . 
Cysticercus cellulosce . . 
Cijsticercus tenuicollis . 
Coenurus cerehralis . . 
Echinococcus ]polymor- 
phus 


Cattle. 

Swine and man. 
Cattle, sheep, and swine. 
Cattle and sheep. 
Cattle, sheep, swine, man, 
etc. 



CYSTICERCUS DISEASE OF THE PIG. 

This disease of the pig is due to Cysticercus cellulosce, the cystic form 
of the Tcenia solium or Tcenia armata of man. As a disease of the pig 
it has been recognised from the most ancient times, and is stated to be 



74 DISEASES OF MUSCLES AND TENDONS. 

the cause of Moses mid Mohammed havmg prohibited the consumption 
of pork by their disciples. In the Middle Ages it formed the subject of 
legislation. It was, ho^yeve^, only when the investigations of Van Beneden 
and Kuchenmeister had completed those of the zoologists of the seven- 
teenth and eighteenth centuries that the evolution of taenire became well 
known and the importance of the cystic phase clearly established. 




Fig. 30. — A piece of pork 
heavily infected with pork 
measles {Gysticercus cellu- 
, natural size. (Stiles, 
Eeport U.S.A. Bureau of 
Agriculture, 1901.) 




Fig. 31.— An isolated pork-nieasle bladder worm {Gysticercus 
celluloses), with extended head, greatly enlarged. (Stiles, 
Keport U.S.A. Bureau of Agriculture, 1901.) 



Causation. The cause of cysticercus disease in the pig may be 
summed up in one phrase — viz., ingestion of eggs or embryos of TcEiiia 
solium. 

Young animals alone seem to contract the disease. After the age of 
eight to ten months they appear almost entirely proof against it. 

It is very rare in animals reared in confinement^ but is relatively 



CYSTICERCUS DISEASE OF THE PIG. 



75 



common in those roaming at liberty 
to discover human excrement and 
the embryos of taenia. The eggs 
having been swallowed, the six- 
hooked embryos are set at liberty 
in the intestine, perforate the 
tissues, enter the vessels, and are 
carried by the blood into all parts 
of the body. Those alone develop 
welhvhich reach the interstitial and 
intermuscular connective tissue. 
The others in the viscera usually 
disappear. Their presence in the 
depths of the muscles produces 
slight general disturbance and 
signs of local . irritation, due to 
the development of the cyst itself. 
At the end of a month the little 
vesicle is large enough to be visible 
to the naked eye ; in forty to forty- 
five days it is as large as a mustard 
seed, and in two months as a grain 
of barley. Its commonest seats are 
the abdominal muscles, muscular 
portions of the diaphragm, the 
psoas, tongue, heart, the muscles 
of mastication, intercostal and cer- 
vical muscles, the adductors of the 
hind legs, and the pectorals. 

Symptoms. The symptoms of 
invasion are so little marked as 
usually to pass undetected. Occa- 
sionally, when large quantities 
have been ingested, signs of en- 
teritis may occur, but these are 
generally ascribed to some entirely 
different cause. In some cases there 
is difficulty in moving, and the grunt 
may be altered. 

Certain authors declare that 
the thorax is depressed between 
the front limbs, but this symptom 
is of no particular value, and is 



because they are much more likely 




Fig. 32. — Several portions of an adult 
pork-measle tapeworm {Tcenia solium), 
natural size. (Stiles, Report U.S.A. 
Bureau of Agriculture, 1901.) 



76 



DISEASES OF MUSCLES AND TENDONS. 




Fig. 33. — Large (a) and small (h) hooks of 
pork-measle tapeworm {TcEnia solhim). 
X 280. (After Leuckart.) 



also common to osseous cachexia and rachitis. Paralysis of the tongue 

and of the lower jaw is of greater importance. In exceptional cases, where 

the cysticerci are very numerous and penetrate the brain, signs of 

encephalitis, vertigo, and turning sickness (gid, sturdy) may be produced. 

These signs, however, disappear, and the cysticerci undergo atrophy. 

Interference with movement may give rise to suspicion when the toes of 

the fore and hind limbs are 
dragged along the ground, and 
thus become worn. This pecu- 
liarity is due to the presence 
of cysts in the muscles of the 
limbs, but it occurs in an al- 
most identical form in osseous 
cachexia. 

One symptom alone is 
pathognomonic, and it appears 

only at a very late stage — viz., the presence of cysts under the thin 

mucous membranes which are accessible to examination, such as those 

of the tongue and eye. 

Visual examination then reveals 

beneath these mucous membranes 

the presence of little greyish-white, 

semi-transparent grains the size of 

a grain of barley, or even larger. 

Unfortunately, in an animal so diffi- 
cult to handle as the pig, this visual 

examination is decidedly troublesome, 

and is usually replaced by palpa- 
tion. In many instances the disease 

does not attract attention during the 

patient's life, and is only discovered 

on slaughter in consequence of the 

lesions by which it is characterised. 
Diagnosis. As the characteristic 

lesions of cysticercus disease are 

to be found in the depths of the 

muscular and connective tissues, and 




Pzr~ -V ^."-rs 



Fig. 34. — Mature sexual segments of 
pork-measle tapeworm (T^ma solium), 
showing the divided ovary on the pore 
side. cjp, Cirrus pouch ; gp, genital 
pore ; n, nerve ; ov, ovary ; t, testicles ; 
tc, transverse canal ; ut, uterus ; v, 
vagina ; vc, ventral canal ; vd, vas 
deferens ; vg, vitellogene gland. X 10. 
(After Leuckart.) 



as the external symptoms may be regarded as of doubtful significance, 
the diagnosis can only be confirmed during life by manual examination 
of the tongue. This examination of the tongue has been practised since the 
earliest times. Aristophanes even speaks of it, and in the Middle Ages 
it was performed under sworn guarantees. The regulations concerning 
the inspection of meat have finally led to the suppression of this calling. 



CYSTICERCUS DISEASE OF THE PIG. 



77 



In this method of exammmg the tongue, the operator commences by 
throwmg the animal on its side, usually on the right side, and holding 
it in this position by placing his left knee on its neck. He then passes 
a thick stick between the jaws and behind the tusks, opens the mouth 
obliquely, raising the upper jaw by manipulating the stick. Finally he 
fixes one end of this last by placing his foot upon it, and holds the 
other extremity by slipping it under his left arm. In this position he 
is able to grasp the free end of the tongue and by digital palpation to 
examine the tongue itself, the gums, the free portions of the frgenum 
linguae, etc. 

If he discovers cysts, the diagnosis is confirmed, but failure to do so 




Fig. 35. — Gravid segment of pork-measle tapewoiim [Tcenia 
soZ«t??i), showing the lateral branches of the uterus enlarged. 
(Stiles, Report U.S.xA.. Bureau of Agriculture, 1901.) 



by no means disposes of the possibility of infection. Eailliet declares 
that about one animal in four or five shows no cysts beneath the tongue, 
and, moreover, fraud is possible in this connection, it being quite possible 
to prick the little cysts with a needle so that the liquid contents escape, 
and examination gives no positive result. For these reasons intra-vitam 
examination alone is now discounted, and the chief reliance is placed on 
post-mortem search. 

Prognosis. The prognosis is- very grave, not on account of danger to 
the lives of the infected, but because infected meat may be ofiered for 
human consumption. Should such meat, in an insufficiently cooked 
condition, be eaten by man, its ingestion is followed by the development 
of Tcenia solium. If cooking were always perfect it would destroy the 



?8 



DISEASES OF MUSCLES AND TENDoNS. 





Fig. 36. — Eggs of pork- 
measle tapeworm {Tcsnia 
sol'kwi) : a, with primi- 
tive vitelline membrane ; 
6, without primitive vitel- 
line membrane, but wdth 
striated embry ophore . 
X 450. (After Leuckart.) 



cysticerci, but the uncertainty in this respect should prevent such meat 

being consumed. The cysticerci are killed at 
a temperature of 125° to 130° Fahr. 

Lesions. The lesions are represented by 
cysts alone — i.e., by semi-transparent bladders, 
each of which contains a scolex or head armed 
with four suckers and a double crown of hooks. 
The httle bladders are most commonly found 
in the muscles, lodged in the interfascicular 
tissue, which they slightly irritate. 

The number present varies extremely, 
depending on the intensity of infestation and 
the number of eggs swallowed. Whilst in 
some cases difficult to discover, in others 

they are so numerous that the tissues 

ai3pear strewn with them. 

They are commonest in the muscles 

of the tongue, neck, and shoulders, in 

the intercostal and psoas muscles, and in 

those of the quarter. 

The viscera — viz., the liver, kidneys, 

heart, lungs, etc. — are less commonly in- 
fested, and in these organs the cysts 

degenerate very rapidly. In animals 

which have been infested for a long time, 

the cysts may even have undergone caseo- 

calcareous degeneration, the liquid being 

absorbed and the lesions presenting the 

appearance of little oblong firm nodules. 
On cutting through masses of muscle 

the vesicles protrude from between the 

bundles. 

In young animals, infestation with 

cysticerci causes wasting and ill-health; 

subsequently the patients improve in 

appearance, later on fatten, and gain 

marketable condition. 

Of the carcases examined in Prussian 

slaughter-houses between 1876 — 82, one 

in every 305 was found infested ; between 

1885^93, one in every 537. ^'^- ^^^--Half of hog, showing the 

_, , i. mi • ,-, , portions most likely to become 

Treatment. There is no curative treat- i^^f.^^,,^ ^^,.^^^ ^^^^^^ ^^^^^^^^^^ 
ment. Only preventive measures are of (After Ostertag.) 




BEEF MEASLES. 



?9 



value. These are confined to rendering it impossible for animals to ingest 
eggs of the 2\enia solium. 

Cj^sticercus disease is rare in the north, centre, and east of France, 
and in districts ^vhere animals are reared in confinement. It is commoner 
where pigs are at liberty, such as Limousin, Auvergne, and Perigord. It 
is frequent in North Germany, where the custom of eating half-cooked 
meat contributes to the propagation of Tcenia solium. It is also frequent 
it Italy. 

BEEF MEASLES. 

Causation. The disease of beef measles is due to the penetration 




Fig. 38. — Cysticercus cellnloscB in pork, c, Cysts; v, fibrous 
tissue capsule which forms around the cyst. 



into the connective and muscular tissues of embryos of the Tcenia sagi- 
nata, or unarmed taenia of man. 

This disease, unlike that of the pig, has only been recognised 
within comparatively^ recent times, and only after Weisse's experiments 
(St. Petersburg, 1841) on feeding wdth raw^ flesh w^as attention drawn to 
it, although as early as 1782 the Tcenia saginata had been described by 
Goeze. 

Measles in the ox is rarely seen in France, but is common in North 
and East Africa. Alix has found it in Tunis, Dupuys and Monod in 
Senee-al, and it is common in the south of Aloeria. The disease is due 



80 



DISEASES OF MUSCLES AND TENDONS. 



simply to oxen swallowing eggs or embryos of the unarmed taenia, a 
fact which ex^Dlains the frequency of the disease in places where the 




Fig. 39. — Anatomy of the Cysticercus cellulosce (after Eobin). A, Cyst; 
B, scolex with hooks ; C, hooks ; D, magnified fragment of cyst. 

inhabitants are of nomad habits, and consequently disregard the most 
elementary rules of public and general hygiene. 

Furthermore, cattle in the Sahara, in Senegal and in the Indies, 

have a very marked habit of eat- 
ing ordure, and as no attempts are 
made to prevent it, the risk to these 
animals is greatly increased. 

As in the pig, the embryos 
which reach the stomach and intes- 
tine penetrate into the circulatory 
system, and are thereby distributed 
throughout the entire organism. 

The development of the cysti- 
cercus is complete in forty days, 
and if swallowed by man in infected 
meat after this period it again gives 
rise to the Tcenia saginata. 

The age of the animals seems of 
less importance than in the case 
of the pig, for Osterag and Morot 
have seen cases of beef measles in 
animals of ten years old. 




Fig. 40. — Section of a beef tongue heavily 
infested with beef measles, natural size 
(Stiles, Annual Keport U.S.A. Bureau 
of Agriculture, 1901). 



BEEF MEASLES. 



81 



Symptoms. The 
symptoms are still less 
marked than in the pig, 
and in ordinary cases of 
infection ahYa3^s escape 
observation. Stiles, how- 
ever, gives the following 
account of a case experi- 
mentally infected : — 

' ' Symptoms . F o u r 
days after feeding seg- 
ments of T. saginata to 
a healthy three-months- 
old calf, the patient 
showed a higher tem- 
perature (the normal 
temperature was 39*2° 
C). The calf ate but 
little on that da}^ showed 
an accelerated pulse, 
swollen belly, staring 
coat, and upon pressure 
on the sides showed signs 
of pain. The next da}' 
the animal was more 
lively, ate a little, and 
for nine days later did 
not show any special 
symptoms except pain 
on pressure of the abdo- 
minal walls, and a slight 
fever. Nine days after 
the infection the tem- 
perature was -iQ'l^ C, 
pulse 86, respiration 22 ; 
the calf laid down most 
of the time, lost its ap- 
petite almost entirely, 
and groaned consider- 
ably. When driven it 
showed a stiff gait and 
evident pain in the side. 
The fever increased 

D.C. 




82 



DISEASES OF MUSCLES AND TENDONS. 



gradually, and with it the feebleness and low-spiritedness of the calf, 
which now retained a recumbent position most of the time, being 
scarcely able to rise without aid, and eating only mash with ground 
corn. Diarrhoea commenced, the temperature fell gradually, and on the 
twenty-third day the animal died. The temperature had fallen to 
38*2° C. During the last few days the calf was unable to rise ; in fact, 
it could scarcely raise its head to lick the mash placed before it. Pulse 
was reduced by ten beats. On the last day the heart-beats were very 
much slower, yet firm, and could be plainly felt. Several days before 

death the breathing w^as laboured, and 
on the last day there was extreme 
dyspnoea." 

Diagnosis. In forming a diagnosis 
we meet with the same difficulty as in 
the case of the pig. It is ah\'ays easy 
to examine the tongue ; but when 
visible lesions are absent diagnosis in 
the case of the ox remains doubtful 
and problematical even more than in 
the pig. 

In the carcase, diagnosis is much 
easier. The cysts are sought for, 
as in the pig, by making sections of 
muscle, those usually selected being 
the pterygoid, cervical, cardiac, and 
psoas muscles, and those of the 
quarters. 

Prognosis. The prognosis is grave, 
not indeed for the infected animals, 
which seem little injured by the para- 
site, but for human beings, who run 
the risk of contracting Tienia inermis 
by eating insufficientlj^-cooked meat. 
A temperature of 115° to 120° Fahr. destroys the cysticerci, but in 
roast meats the central temperature of the mass ahvays remains below 
this figure. 

Salting for fifteen to twenty days destroys the vitality of the parasite. 
Lesions. The lesions are confined to the presence of the cyst and 
of two httle zones of chronic inflammation immediately surrounding it. 
Unless heavily infested the subjects fatten just as well as others. 

The vesicles are semi-transparent, ^^ inch to \ inch in length, slightly 
ovoid in form, and contain a taenia head with four suckers, but without 
hooks. 




Fig. 42. — Apex, dorsal, and lateral 
views of the head of beef-measle 
tapeworm {TcEiiia saginafa), show- 
ing a depression in the centre of the 
apex. X 17. (Stiles, Keport U.S.A. 
Bureau of Agriculture, 1901.) 



BEEF MEASLES. 



83 



In seven to eight months the cysts undergo degeneration, the Hquid 
is absorbed, and calcium salts are deposited throughout the mass. The 
lesions which remain have, in the ox, the appearance of interstitial 
disseminated tuberculosis. 

There is no curative treatment. The infested animal recovers spon- 
taneously with the lapse of time, for the cysticerci undergo degenerative 
processes, but the flesh of such animals is of little commercial value. 

From a preventive standpoint we can only hope to improve matters by 
a gradual and progressive change in social and public hygienic conditions. 

When the life of the nomad shall have been entirely replaced by 
that of the highly-civilised European and private hygienic precautions 




Fig. 43. — Sexually mature segment of beef-measle tapeworm {Tcenia 
saginata). c.]j., Ciniiiis pouch with cirrhus ; d.c.^ dorsal canal; 
g.p., genital pore; n., lateral longitudinal nerves; ov., ovary; 
s^., shell- gland; i^., testicles ; 2^^., median uterine stem, enlarged (in 
part after Leuckart) ; v., vagina ; v.c, ventral canal, connected by 
transverse canal; /c, vd., vas deferens; vg., vitellogene gland. 



have rendered it impossible for animals to obtain access to segments or 
eggs of the Tcenia saginata, beef measles will disappear. 

At present, in the countries where the disease is common, one 
experiences a feeling of astonishment that it is not far more frequent; 
for experiment has shown that a person infected with one unarmed 
tapeworm expels with the faeces an average of four hundred proglot- 
tides per month, each proglottis or segment of the worm containing 
about 30,000 eggs, each of which is capable of developing into a 
tapeworm. 

G 2 



84 



DISEASES OF MUSCLES AND TENDONS. 



Beef measles is rather common in Germany, but rare in France, 
Switzerland, and Italy. 

TRICHINIA.SIS-TRICHINOSIS, 

Trichinosis is a disease caused by the entrance into the body of the 
Trichina spiralis. This parasite is swallowed in the larval form, and 
undergoes sexual changes in the intestine, at first producing intestinal 
trichinosis, which represents the first phase in the development of the 
disease. 

The trichina breed rapidly. The embryos penetrate into or are 
directly deposited in the blood-vessels, which convey them to all parts of 




Fig. 44. — Gravid segment of beef- 
measle tapeworm [Tcenia sagi- 
nata), showing lateral branches 
of the uterus, enlarged. (Stiles, 
Annual Keport U.S.A. Bureau 
of Agriculture, 1901.) 




Fig. 45. — Egg of beef-measle tapeworm 
{Tcenia saginata), with thick egg-shell 
(embryophore) , containing the six- 
hooked embryo (oncosphere), enlarged. 
(After Leuckart.) 



the body, thus setting up the second phase of the disease, known as 
muscular trichinosis. 

Trichinosis as a disease has long been recognised. Peacock in 1828 
and J. Hilton in 1832 mentioned the existence of the cysts of trichinse ; 
Owen in 1835 gave the name of Trichina sjyiralis to the parasites con- 
tained in the cysts. Trichinosis being common in Germany at that time, 
Virchow and Leuckart undertook its investigation, but mistook other 
nematodes of the intestine for the Trichina' spiralis. In 1847 Leydy 
recognised that trichinosis occurred in American pigs. 

In 1860 Zenker found muscular and intestinal trichinosis on post- 
mortem examination of a girl who had been suspected of suffering from 
typhoid fever, and a carefully conducted inquiry revealed the fact that 



TKICHTNIASIS — TRICHINOSIS. 



85 



this girl had some time previously eaten a quantity of raw ham. Yirchow 
and Leuckart returned to their investigations, and the life history of the 
parasite soon became definite^ known. 

Causation. Trichinosis is capable of attacking all mammifers with- 
out exception, from a man to a mouse ; and most animals which can be 
made the subjects of experiment contract the disease in varying degrees. 
The intestinal form is seen in birds, but the muscles do not become 
infested by the embryos. 

Cold-blooded animals are proof against the disease. 
After the ingestion of meat containing cysts of the parasite, the 
processes of gastric and intestinal digestion set the larvae at liberty. 
These larvse become sexual at the end of four 
to five da3^s, and the females, w^hich are usually 
twice as numerous as the males, begin laying 
eggs from the sixth day, continuing for a 
month to six Aveeks. Each female lays 
ap23roximately from 10,000 to 15,000 eggs. 
The embryos perforate the intestinal walls, 
pass into the circulation, and are hurried into 
all parts of the sj^stem. This period of infes- 
tation constitutes the first phase of the disease. 
Askanaz3% in 1896, suggested that it was 
not the embryos which perforated the intes- 
tinal walls and thus reached the blood-vessels, 
but the fertilised female trichinae themselves, 
which entered the terminal chyle vessels and 
laid their eggs directly within them. 

This observation is of great interest, for 
it contradicts the view held by Leuckart and 
proves that treatment is useless even in the 
first phase. 

The males are about -f^ inch in length, the females | inch to jV inch, 
and are ovo viviparous. 

Symptoms. The symptoms lack precise character, even when the 
disease is known to be developing, and moreover they have onl}^ been 
carefully observed in experimental cases. As soon as the laying period 
begins, signs of intestinal disturbance may be observed, possibly due to 
embryos perforating the intestinal walls (if we accept Leuckart's view), or^ 
according to Askanazy, to adult females penetrating the chyle vessels and 
disturbing intestinal absorption. 

These symptoms are only appreciable in cases of "massive " infesta- 
tion. If slight, the disturbance passes unperceived. In severe cases 
the sj'mptoms consist of diarrhoea, loss of appetite, grinding of the teeth. 




Fig. 46. — Male trichina from 
the mtestme. (Cohn.) 



86 



DISEASES OF MUSCLES AND TENDONS. 



abdominal pain in the form of dull colic, and sometimes irritation of the 
peritoneum. The embryos carried by the circulation then escape into 
the tissues and, like the cysticerci, become encysted, preferably in the 
muscles, in the interfascicular connective tissue towards the ends of the 
bundles. Each (asexual) parasite plays the part of a foreign body, 
causing infiltration of serum and exudation of leucocytes in its neighbour- 
hood, and soon becoming encysted in the interior of a little ovoid space 
surrounded by a fibro-fatty wall. Fat granules accumulate at each end 
of the cyst. 

The parasite, which at first appeared straight, soon assumes a bent 
form, then that of a figure " 6," then of a figure " 3," and preserves a 





Fig. 47. — Free larval 
trichina. (Colin.) 



Fig. 48. — Trichinae encys- 
ted in the muscular 
tissue. (Colin.) 




Fig. 49.— Old (degene- 
rated) trichina cyst. 
(Colin.) 



latent vitahty throughout the entire period of encystment. These cysts 
are of very small dimensions, invisible to the naked eye, and their 
discovery necessitates the use of the microscope. They are about g^th 
inch in length and ^ioth inch in width. Very frequently two or three 
cysts may be found arranged in line, presenting the appearance of 
beads on a string : more rarely two parasites may be found in one cyst ; 
exceptionally, as many as six or seven. The appearance of '' beads on a 
strmg" is due to the fact that the parasites follow the interfascicular 
capillaries. 

In animals which are kept for a long time and fattened the cyst walls 



TRICHINIASIS — TRICHINOSIS. 87 

undergo fatty infiltration. The change is commonest in pigs. In the 
same way calcareous infiltration sometimes occurs, but only when the 
parasites have lost their vitality. This calcareous degeneration consists 
in the deposit of carbonate and phosphate of lime in the walls of the cyst ; 
it never begins before the seventh or eighth month after infestation, 
and is sometimes much longer delayed. 

No man or animal ever becomes infested except by the ingestion of 
meat or drink containing larval trichinae. The pig and small rodents 
are most frequently attacked. Man contracts trichinosis by eating in- 
sufficiently cooked infected pork. The fact that small rodents, par- 
ticularly rats, eat the bodies of their kind explains the persistence of 
trichinosis in certain regions. Pigs roaming at large, and thus liable 
to find and eat the dead bodies of such rodents, may contract trichinosis 
in this way or from eating ordure. 

For some weeks after the larvse have penetrated the muscular tissues 
the animals show stiffness of the limbs, difficulty in moving, and in 
mastication, etc., but these troubles disappear in a short time. 

The above facts explain why trichinosis in the pig is almost unknown 
in France, Italy, and Spain. It is commoner in Germany and in certain 
States of Europe, such as Holland and Eussia, although investigations 
had previously shown that in Paris about 7 per cent, of the sewer rats 
were sufferers from trichinosis and that in Germany the percentage rose 
as high as 15 to 20. In Chicago and Cincinnati, U.S.A., the proportion 
of rats suffering from trichinosis has been as high as 50 to 70 per cent., 
and as in some of the Northern States pigs were bred in complete 
freedom, it follows that at one time very large numbers of American pigs 
must have suffered from trichinosis. 

In consequence of sanitary precautions this proportion has since 
greatly diminished. 

Diagnosis. During the animal's life diagnosis is a difficult matter, 
though, on the other hand, simple microscopic examination of suspected 
meat is sufficient at once to settle the question. In dealing with the 
living animal, however, it is necessary, as in examining suspected meat, 
to obtain a fragment of muscle in order to submit it to microscopic 
examination. This fragment can be obtained by the method known as 
" harpoonage " — a trocar provided with a cutting hook, or a trocar the 
canula of which has a sharp-edged opening near its end, being thrust 
into the muscle. On removing the trocar the elasticity of the tissues 
causes a fragment to project into the opening in the canula, and on with- 
drawing the latter a fragment sufficient for examination is obtained. 
One may proceed in the same way by harpoonage when examining large 
masses of suspected meat the surface of which reveals no lesion. 

The specimen having been obtained, a few fragments of the 



88 DISEASES OF MUSCLES AND TENDONS. 

muscular fasciculi are crushed between two glasses and examined 
with a low power. 

The trichinae will be found towards the ends of the muscle near 
the region of the tendons ; few or none exist in the fat. These 
parasites are most readily discovered in the diaphragm, in the 
muscles of the shoulders and quarters, and in the psoas muscles. 

Prognosis. The prognosis is relatively favourable so long as infesta- 
tion is only moderate. But it is very grave from the point of view 
of public hygiene, on account of the possibility of persons becoming 
infected by eating the diseased meat. 

Treatment* There is no curative treatment. Formerly it was 
believed that, provided the condition were early diagnosed, the intes- 
tinal form might possibly be cured by administering purgatives and 
vermifuges so as to prevent the embryos penetrating the system. 

After Askanazy's discoveries this view had to be abandoned, and 
the practitioner is necessarily powerless in dealing with the muscular 
form. Time alone effects improvement and a relative cure by causing 
caseo-calcareous degeneration of the cysts. With a prophylactic object, 
every precaution should be taken to prevent the possibility of pigs being 
contaminated. This question particularly interests America, because of 
the extreme prevalency of pig trichinosis there. 

From the point of view of public hygiene all infected meat should 
be seized and destroyed, despite the fact that perfect cooking destroys 
the vitality of the parasites, which j)erish at 120° Fahr. 

Ordinary salting but slightly affects their vitality, which explains 
why from time to time the importation of meat has to be prohibited 
and why meat should always be scrupulously inspected. 



CHAPTER V. 
RHEUMATISM. 

In bovine pathology the term " Eheiimatism " is apphed to a number 
of different morbid conditions, the sole connection bet^Yeen which is that 
the}" seriously affect the organs of locomotion. This reason may perhaps 
be accepted as sufficient for including the study of rheumatism amongst 
diseases affecting locomotion. 

The disease is of considerable importance, and for this reason the 
study of rheumatism itself necessarily precedes the description of 
pseudo-rheumatism, secondary rheumatism, or infectious rheumatism 
in young and adult animals. 

ARTICULAR RHEUMATISM. 

Acute rheumatism has a clearly marked predilection for the arti- 
culations. Sometimes the great serous membranes are simultaneously 
affected (pleura, pericardium, endocardium), but only in very exceptional 
circumstances are they primarily attacked. That form of rheumatism 
known as visceral is as a general rule secondary in comparison with 
articular rheumatism. Several joints and tendon sheaths may be 
attacked at the same time. Under such circumstances rheumatism 
may be defined as a febrile disease, probably of an infectious nature, 
revealing itself by simple or multiple inflammation of joints and the 
tissues surrounding them, and capable of becoming complicated with 
inflammation of the pleura, pericardium, endocardium, meninges of 
the brain, etc. 

Causation. All authors agree in recognising the influence of 
heredity, of wet and cold, of sudden changes in temperature, draughts 
in the stable, prolonged exjDosure to low temperatures, or the chilling 
of animals saturated with perspiration. These are and cannot be other- 
wise than occasional causes ; but the determining cause remains at 
present unknown. 

In human pathology it has been proved beyond dispute that a certain 
relationship exists between arthritism, or the " uric acid diathesis," and 
rheumatism. This fact is so well recognised that doctors have said that 
rheumatism was to arthritism what scrofula is to tuberculosis. That, 



90 HHEUMATISM. 

however, does not advance our kno^Yledge of the question in the smallest 
degree, and it may simply be that arthritism represents one of the 
principal favouring conditions in the development of rheumatism. 

In domestic animals the uric acid diathesis is little known, renal 
lithiasis is no more a rarity than gravel ; but at the present time no 
one appears clearly to have established the relationship between these 
diseases and the development of rheumatism. What, however, we must 
all admit is that rheumatism exhibits all the phases of development of 
a rapidly progressive infectious disease. 

Numerous attempts have been made by doctors during the last few 
years to discover the presence of a microscopic agent and to demonstrate 
its pathological characteristics. Several microbes have been described, 
but one is forced to confess that the results have until now been very 
contradictory and uncertain ; and yet there is little room to doubt that 
the disease is of an infectious character. 

Symptoms. The symptoms are generally well defined and well 
developed. The onset is sudden ; an animal w^hich one day before 
appeared perfectly well is attacked in one or several joints. Usually 
the upper joints of the limb are involved — the shoulder, elbow, knee, 
haunch, stifle, hock. 

Nevertheless, invasion is probably not as sudden as it appears to 
be, and, as in the human species, the subject begins by feeling erratic 
pains, which, however, pass unnoticed. The animal moves with diffi- 
culty, as though it w^ere suffering from laminitis, and has pain when 
placing weight on the limb, while the joint attacked soon shows a 
swelling w^hich extends to the tendon sheaths and the neighbouring 
serous bur see. The local temperature is higher than that of sur- 
rounding parts, sensibility becomes very marked, and pain attends 
the slightest pressure on, or even movement of, the affected joint. 
Intense lameness follows, which may even at first give rise to the 
suspicion of fracture. The animals remain lying for long periods, 
groan from time to time, and suffer great pain when rising. 

In some cases the local manifestations appear to be transferred 
from one joint to another. 

These local symptoms are accompanied by high fever. The 
temperature rises to 105° or 106° Fahr., the pulse to 80 or 90, and 
the breathing is enormously accelerated if the patients are forced 
to move. 

Loss of appetite is very marked. Eumination may be suspended, 
and these grave symptoms are accompanied by constipation, rapid 
wasting, cessation or marked diminution of the milk supply, decrease 
in the quantity of urine passed, etc. 

A few days after the onset, visceral complications may occur, though 



ARTICULAR RHEUMATISM. 91 

fortunately such complications are far from being constant. Auscultation 
and percussion sometimes reveal the lesions of pleurisy, endocarditis, 
pericarditis, etc. 

The development of articular rheumatism varies greatly, and may 
occasionally continue for weeks or months, the condition of one joint 
improving only to be followed by inflammation of another. 

The visceral lesions rarely disappear completely, and it is not un- 
common to note sym23toms of chronic valvular endocarditis. Eelapses 
are somewhat frequent, and the disease may continue in a chronic form 
after the acute symptoms have disappeared. 

Lesions, The joint itself is not alone affected. All the tissues sur- 
rounding it are congested, swollen and painful, particularly the sheaths 
and insertions of the tendons. Within the inflamed sj^novial capsules 
of the joints an increased quantity of turbid synovia accumulates, dis- 
tending the joint and producing a condition of hydrarthrosis. 

In animals slaughtered during the course of the disease one finds 
congestive infiltration of the limbs. 

The temperature of the parts near the afiected joints is higher than 
that of neighbouring regions. Sensibility is much more acute, and the 
slightest external pressure gives rise to pain. 

In favourable cases the joint may appear scarcely injured. The 
principal symptoms are those of pain. In old-standing cases certain 
IDermanent changes may occur, such as thickening and hardening of the 
wall of the synovial cajDsule, fibrous infiltration of the tissues around the 
joint, or even diffuse and irregular calcareous infiltration. 

Cases of false or true anchylosis are rare, the animals usually being 
slaughtered before such conditions can develop. 

Complications. _ The commonest complications are endocarditis and 
pericarditis. Valvular endocarditis localised in the auriculo-ventricular 
valves is revealed by a systolic sound, and by tumultuous or irregular 
beating of the heart when the animals are forced to move. Pericarditis, 
which seems rare in bovine animals, is much commoner in sheep. This 
pericarditis, however, produces none of the external signs of pericarditis 
due to a foreign body. Like tuberculous pericarditis, it is only accom- 
panied by a trifling amount of exudate, and is recognised by increased 
cardiac dulness and diminution in the cardiac sounds on auscultation. 

Simple pleurisy associated with pericarditis is frequent in sheep, but 
unknown or little known in the ox. 

If in animals other visceral complications occur, aftecting the peri- 
toneum, meninges of the brain or intestines, they are at present little 
recognised. 

Diagnosis. Articular rheumatism can only be confused with osseous 
cachexia or laminitis. Osseous cachexia, however, possesses symptoms 



92 RHEUMATISM. 

peculiar to itself, and generally extends to an entire district, whilst 
rheumatism appears in an isolated form. Again, the arthritis peculiar 
to osseous cachexia most commonly affects the joints of the extremities 
(fetlock and phalanges) . The disease may be differentiated from laminitis 
by simply manipulating the joints, which are painful in rheumatism 
but not in laminitis, and by percussing the claws, which are painful in 
laminitis but not in rheumatism, and by noting the character of the gait. 

Prognosis. The prognosis is grave, as in all acute diseases which 
are capable of assuming a protracted chronic form. It is also necessary 
to take into account the loss of condition; the possibility of relapse, and 
the complications due to prolonged decubitus. 

Treatment. The first indication is to place the patients in a nearly 
constant temperature, to supply bedding generously, and to arrange for 
the animal being undisturbed. Among drugs salicylate of soda gives the 
best results if administered in sufficient doses — 6 to 7 drams per day for 
oxen or cows of medium size, 45 to 75 grains for sheep. 

Diuretics, like bicarbonate of soda, nitrate of potash and hay tea or 
infusion of couch grass, pellitory, etc., also give good results. 

The joints attacked may be blistered, but it is often preferable to use 
mild ointments, containing camphor or belladonna, because, as soon as 
pain diminishes, moderate massage of the affected parts, which favours 
raj^id absorption of the effusions, can then at once be resorted to. The 
diet should consist of easily .digested food and of lukewarm hay tea, etc. 
When the animals are suffering from kidney disease in any form 
salicylate of soda is contra-indicated. 

Antipyrin may also be of service in doses of 45 to 75 grains for bovines 
and 15 grains for sheep. Preparations of methyl salicylate can only be 
used for animals of value. 



MUSCULAR RHEUMATISM* 

Muscular rheumatism is due to causes similar to those of articular 
rheumatism. The symptoms, moreover, often occur simultaneously, or 
may alternate with the articular manifestations, with which they are 
seldom entirely unconnected. 

Moist cold seems to be the predetermining cause, whether it acts 
indirectly on the nerve trunks or affects the capillary circulation in the 
muscles, through the medium of the vaso-motor supply. The results are 
revealed by the development of neuralgia, neuritis or interstitial myositis; 
and these diseases, by producing more or less intense pain, cause 
difficulty in movement or distinct lameness. Attempts have been made 
to explain the development of these lesions by ascribing a certain action 
to the uric acid (which is said to be in excess in the body), and to the 



MUSCULAR RHEUMATISM. 93 

lactic acid, which accumulates in the muscular tissue after fatigue or 
over-exertion, and may occasionally produce temporary myositis. Up to 
the present time, no satisfactory proof has been furnished enabling us 
to identify the myositis of rheumatism with the mj^ositis of over-exertion, 
which, moreover, appears to differ from it in essential particulars. 

Symptoms. Muscular rheumatism is often ill-recognised in veterinary 
medicine, and closer observation would appear to suggest that it is 
much less frequent than has been stated. Generalised muscular rheu- 
matism is rare ; patients stand stiffly as though incapable of moving ; 
the limbs and the back appear rigid, and the animal seems only capable 
of changing its position by a single movement of its whole body. One 
might readily believe at first sight that the case w^as one of generalised 
laminitis or slight generalised tetanus. The animal has difficulty in 
rising ; when moving the limbs are dragged, and the patient is cautious 
in lying down. 

Most frequently the disease is localised in one region, such as the 
shoulder, the loins, or the quarters. The affected part is stiff, tense, 
painful, hard, and as though in a state of cramp. Palpation and pressure 
reveal the 25i'esence of very exaggerated sensibility, which varies within 
wide limits, according to circumstances, changes in atmospheric con- 
ditions, etc. These local signs are accompanied by a general reaction of 
varying severity, somewhat resembling that seen in articular rheumatism. 
Appetite is diminished or suppressed, as is rumination ; the muzzle is dry 
and hot ; the temperature may rise as high as 103° or 104° Fahr. 

Lesions. . The lesions are imperfectly recognised, because those who 
might most easily observe and study them have often neither the means 
nor the leisure for the purpose. Possibly one would at times discover 
lesions of neuritis ; but in any case it is not so very rare to discover 
lesions of interstitial sclerosing myositis in the depths of the muscles of 
the quarter, loins, shoulders, etc, a condition rarely found in any other 
disease. Naturally these are only the ultimate lesions of muscular 
rheumatism ; for slight attacks leave no traces visible to external 
examination. 

Diagnosis. The commonest error is that of mistaking the condition 
for laminitis of all four limbs. The history often suffices to eliminate 
this disease from consideration, while palpation and percussion of the 
claws remove any remaining doubt. 

The prognosis is not usually grave, and recovery sometimes follows 
the adoption of good hygienic conditions. On the other hand, certain 
patients lose flesh rapidly. 

Treatment. Salicylate of soda and antipyrin still form the two most 
efficacious drugs, particularly the first, which may almost be regarded as 
a veritable specific in rheumatism. The doses vary with the size of the 



94 RHEUMATISM. 

patients, from 2J^ to 7 drams per day. These doses are continued for six 
to eight days consecutively. Some authors prefer sahcyKc acid, which, 
however, is more irritant, in doses of 15 to 75 grains. Tartar emetic, in 
doses of 2 J to 4 drams per day until purgation is established, is also said 
to have proved of great value in the hands of the older practitioners. 
Local treatment comprises stimulating frictions with camphorated alcohol, 
ammonia, and oil of turpentine. Such applications are usually of great 
service, particularly when associated with methodical massage of the 
affected parts. These modes of treatment should he supplemented with 
a proper dietary and the administration of tepid, diuretic fluids as 
required. 

Infectious Forms of Eheumatism or Pseudo-Kheumatism. 

Under the head of infectious rheumatism or pseudo-rheumatism may 
be grouped joint diseases of a rheumatic type accompanying various 
general or local diseases in young animals and adults : diseases of the 
umbilicus, rachitis, peri-pneumonia, retention of the foetus, dysentery, 
etc. These diseases are characterised by articular symptoms, which 
sometimes appear early, sometimes only when the disease itself is 
declining, and develop suddenly or gradually, the joint cavities them- 
selves either being directly invaded by the agents of the primary disease 
or remaining exempt. These pseudo-rheumatic attacks are due to the 
localised action of microbic toxins on the articular synovial membranes. 
Sometimes the serous membranes of the large body cavities are also 
implicated. 

This theory explains the development of acute arthritis without the 
presence of gonococci during the course of an attack of blenorrhagia in 
man, and may be applied in respect of certain forms of arthritis or 
synovitis without the presence of microbes in domestic animals. 

INFECTIOUS RHEUMATISM IN YOUNG ANIMALS. 

Causation. To explain the occurrence of infectious rheumatism in 
young animals a variety of causes has been invoked, such as bad feeding, 
the absence of that purgation which usually follows the action of the 
mother's first milk {i.e., colostrum), and clears the bowel of meconium, 
the effect of heredity, of chills,, of insufficient food, and of unduly abun- 
dant or very rich food, which has been said to produce indigestion and 
its various complications. 

All these causes may play a certain part in favouring the develop- 
ment of infectious rheumatism, but none constitutes the direct cause. 

Lecoq and Loiset in their investigations regarding this disease in 



INFECTIOUS RHEUMATISM IN YOUNG ANIMALS. 95 

colts mentioned the almost invariable existence of lesions in the umbilical 
region. Bohnger in 1869 recognised the possibility of infection byway 
of the mnbilical vein. Roll and Guillebeau are of the same opinion, and 
Morot's excellent study shows that here must be sought the most fre- 
quent point of origin of the articular symptoms. In animals born in dirty 
stables the umbilical cord becomes infected at the time of birth, or its 
cicatrix a few days later. The result is the development of rapidly fatal 
septicaemia, suppuration in the wound, omphalitis, omphalo-phlebitis, or 
umbilical arteritis ; and to this infection are due the various complications, 
which may appear almost immediately, as in the case of septicaemia of 
calves, or may be deferred for a shorter or longer interval, for so long indeed 
that the umbilicus may appear to have healed externally (infectious pneu- 
monia and endocarditis, infectious arthritis, etc.). The umbilical cord 
and the tissues surrounding the cicatrix form excellent culture grounds 
for those micro-organisms which alwaj^s exist in such abundance in litter 
and manure ; and there is, therefore, no difficulty in understanding why in 
dirt}" stables infection so readily occurs. The infective agents may be of 
very varying kinds, a fact which explains the difference in the symptoms 
which follow umbilical infection ; although ovoid bacteria, streptococcus 
pyogenes, and the bacilli of necrosis seem most common. 

Omphalitis and omphalo-phlebitis are not the only diseases capable 
of producing infectious rheumatism in .young animals. Certain infections 
resembling dysentery and diarrhoeic enteritis are also its frequent 
forerunners. In young animals even rachitis, which is accompanied 
by various digestive disorders, may serve as the point of origin for 
infectious rheumatism and all its complications. 

In older animals — i.e., in animals from five to six months, or even twelve 
to fifteen months — infectious rheumatism may occur without a clearly 
defined cause. It then develops with the S3miptoms and lesions of that 
condition known as " osteomyelitis of adolescence" in human pathology. 
These forms of osteomyelitis are due to infection with streptococci 
and staphylococci. In veterinary medicine the pathogeny has not yet 
been accuratel.y ascertained. 

Symptoms. Infectious rheumatism in young animals assumes one 
of two clinical appearances, possibly due to different causes, viz. — plastic 
or suppurative arthritis following umbilical infection, and simple 
exudative arthritis. In the former variety symptoms appear soon after 
birth, rarely after the age of two months, and as an exception in animals 
of six to eight months affected with rachitis. The onset is sometimes 
sudden ; the patient, though healthy on the previous evening, is un- 
able next morning to rise or move. Hence in France this disease has 
received the titles, amongst others, of laminitis and paralysis of the 
newly born. 



9G 



RHEUMATISM. 



Certain joints, often a pair, appear swollen, hot and painful. The 
synovial sacs are distended, and in the upper joints of the limb appear 
much more prominent than in the lower. When the patients are still 




\iMm^P»f; 



Fig. 50. — Young bull suffering from infectious rheumatism. 



able to move they walk on three legs, but usually they remain lying 
permanently, and if aroused show great difficulty in rising and very 
acute pain in moving. 

General disturbance is also very marked ; the temperature varies 
between 103° and 105° Fahr. The animals are dull, have no appetite, and 

exhibit intense thirst. The 
pulse rate and respirations 
are increased, and not un- 
commonly symptoms of grave 
visceral complications, such 
as endocarditis, pleurisy, 
pneumonia, etc., can be de- 
tected. Diarrhceic enteritis 
sometimes appears as a 
secondary development. 

The animals remain per- 
manently lying down. They 
can only be induced to rise 
with difficulty, and, Avhen 
moved, exhibit very acute 
pain. 

In many cases the disease then takes a rapid course and ends 
fatally. Death is the usual termination whenever any of the above- 
mentioned visceral complications exist. Kecovery is exceptional. In 




Fig. 51. — Attitude when walking of a calf 
suffering from infectious rheumatism. 



INFECTIOUS EHEUMATISM IN YOUNG ANIMALS. 97 

certain lucky cases, sometimes without any treatment whatever, the 
symptoms become less acute, the appetite persists or improves, fever 
diminishes, the condition of the joints remains stationary, and after the 
lapse of several weeks there is ground for anticipating recovery. In all 
cases, however, the convalescents remain thin and sickly, exhibit pain 
and capricious appetite, and in very few cases indeed is there any economic 
reason for keeping them alive. 

More frequently infectious rheumatism terminates by abscess forma- 
tion in the joints. The articular cavity becomes filled with pus, the 
tissues covering one of the synovial sacs soften, and the abscess opens, 
discharging fibrinous clots, thin watery pus mixed with synovia, 
and debris of articular cartilages or ligaments. Pyaemia is the final 
complication when the patients are not slaughtered. 

In the cases comprised under the second heading the symptoms 
appear more slowly and develop insidiously, the chief, viz., a tendency 
to remain lying and difficulty in movement, long preceding the appear- 
ance of exudative arthritis. The course depends chiefly on the nature 
of the infective agent. In calves suffering from peripneumonia, calves 
from stables in which epizootic abortion rages, rachitic calves or calves 
suffering from severe diarrhoeic enteritis, the joints do not become 
the seat of suppuration. 

In such cases the arthritis is of a simple exudative character, but 
without microbic infection of the joint cavity. This form is less 
dangerous, and is often curable provided the original cause be kept 
in mind. 

Lesions. The lesions are always very marked, and are quite 
different from those of simple rheumatism. The synovial membranes 
and the periarticular tissues are always thickened, injected, inflamed, 
and infiltrated. 

In more benign cases the synovial exudate from the joint cavities 
is simply cloudy, contains no infectious germs, and proves sterile on 
attempts at cultivation. In such cases there is no abscess formation. 
But most frequently this stage of serous exudation is only temporary, 
and the articular fluid, which at first seems sterile, may, w^hen tested 
some days later by means of cultures, reveal the presence of organisms. 
The synovia accumulated within the joint sometimes contains fibrinous 
flocculi, which are at first small, but later form veritable coagula, filling 
up and thickly coating all the prominences of the joint and moulding 
themselves on the extremities of the bones constituting the articulation. 
Sometimes the cartilages undergo very rapid ulceration, the subjacent 
layers of bone become inflamed, and the osteoarthritis which develops 
is so severe and painful that the patients are forced to remain abso- 
lutely still, and are quite incapable of rising. The lesions may 

D.C. H 



98 EHEUMATISM. 

remain stationary at this point. In other cases suppuration occurs in 
the articulation itself, the wall of the synovial cavity, the periarticular 
tissues, and the skin soften ; then the abscess breaks, giving rise to open 
suppurating arthritis. Animals are rarely kept long enough to become 
so gravely affected ; many die before this stage, and the others are 
usually slaughtered. Moreover, they rapidly perish from exhaustion 
and from visceral complications of a pyaemic character. 

In many cases post-mortem examination reveals nothing whatever in 
the region of the umbilical cord (through which infection has occurred), 
but the germs of infection may be found in the blood or general 
circulation ; or again, careful investigation may show ulceration of the 
umbilicus, lesions of omphalitis, of ascending umbilical arteritis in 



/ 






Fig. 52. — Ulceration of the articular cartilage in infectious rheumatism. 

consequence of infection of the thrombus, of umbilical phlebitis, or of 
infective peritonitis, etc. The infectious agent reaches the liver through 
the blood-vessels, then attains the posterior vena cava, after which the 
infection assumes the gravest possible character, producing complications 
like arthritis and purulent infection, with the formation of multiple 
abscesses in the depths of the viscera. 

The Staphylococcus aureus and various streptococci are the most 
frequent but not the only causes of these infections. 

The diagnosis is not difficult, provided the disease be not mistaken 
for true rheumatism. As true rheumatism is very rare in young animals, 
and as, on the other hand, attention is aroused by the presence of 
lesions of the umbilicus and by the existence of diarrhceic enteritis, 
rachitis, etc., there is seldom room for doubt. 

Prognosis. The prognosis is extremely grave whenever the case 



¥ 



INFECTIOUS PSEUDO-RHEUMATISM IN ADULTS. 99 

results from infection of the umbilicus. French statistics place the 
mortality at 90 per cent, and German at 75 per cent. 

Curative treatment can only be attempted with any chance of success 
in the simple exudative form. Even then it is necessary to simultaneously 
treat the primary disease, such as rachitis or diarrhoeic enteritis. 

The recommendations of former practitioners as to the use of saline 
purgatives, cream of tartar, etc., were probably due to their having recog- 
nised that diarrhoea is sometimes the ^^i^iniary cause. 

Moussu has seen simple exudative arthritis in rachitic subjects 
disappear, together with the rachitis, under proper treatment. 

The indications therefore are, firstly, to take measures against the 
primary disease, treating the local lesions separately with blisters, douches, 
or simply cold applications and massage. Provided the general condition 
can be improved, recovery may follow. 

Unfortunately, this treatment is useless against infectious rheumatism 
with suppurative arthritis resulting from infection of the umbilicus. In 
such cases treatment, if undertaken, should be directed towards perfectly 
disinfecting the umbilical wound or any existing sinuses. 

Injections of strong carbolic solution, the application of antiseptic 
ointments or of antiseptic pencils containing iodoform, salol, etc., into the 
sinuses, followed by a surgical dressing covering the umbilicus, form the 
basis of this primary treatment, which, it need scarcely be said, has little 
chance of checking the course of already existing arthritis. The use of 
internal antiseptics and of antipyretics like camphor, salicylate of soda, 
etc., is worthy of trial. On the other hand, prophylactic treatment in an 
infected area has every chance of succeeding. The use of dry, clean 
litter under the mother and the new-born calf, thorough cleansing of 
the umbilical cord or umbilical cicatrix, and the application to the 
umbilicus of a small surgical dressing or even a smear of tar, almost 
always suffice to prevent the occurrence of these forms of arthritis. 

INFECTIOUS PSEUDO'RHEUMATISM IN ADULTS. 

The infectious pseudo-rheumatism of adults differs from infectious 
rheumatism in young animals in that it never becomes complicated 
with suppurative arthritis, and rarely affects more than one joint at 
a time. The hind limbs are the parts usually attacked, and the joints 
seem predisposed to disease in the following order of frequency : the 
femoro-tibial, coxo-femoral, and hock joints. 

On account of its greater frequency in cows, it has been termed 
"arthritis of milch cow^s " and "infectious arthritis of milch cows," etc. 
In reality it may also attack bulls and oxen, but such cases are 
exceptional. 

I. era H 2 



100 



RHEUMATISM. 



Causation. First mentioned by Coulbeaux in 1824, and by Pauleau 
in 1832, this disease has been well-studied by Ph. Heu. Old works 
mention it as attacking good milkers in the best dairies around Paris, 
and Heu declares it to be the most deadly disease after peripneumonia 
and tuberculosis. 

This form of arthritis usually appears in an insidious form after 
abortion, retention of the foetus, or post-partum metritis. In cases of 
epizootic abortion infectious rheumatism sometimes assumes an epizootic 
form, and completes the devastation begun by abortion. Under other and 
much rarer circumstances it may follow enteritis of adults or attacks 
of mammitis, etc. The pathogeny of these forms of arthritis is not 




Fig. 53. — Infectious rheumatism. Arthritis of the left stifle joint. 



difficult to understand, for in the greater number of instances they form 
delayed consequences of local uterine infection. 

The soluble products secreted by infectious organisms multiplying 
within the uterus are absorbed by the uterine mucous membrane, causing 
slow intoxication ; and in consequence of the special elective affinity 
which the toxins show for the articular serous membranes, and in many 
cases also for the visceral serous membranes, the special characteristics 
are developed. Under certain circumstances the joint cavity may even 
become the seat of true microbic infection. 

Symptoms. The appearance of the first symptoms is difficult to 
identify, for many cows abort, fail to " cleanse," or become affected with 
metritis without infectious rheumatism supervening. It is a long-delayed 
condition, which may be postponed for weeks or even for several months 
after an abnormal parturition, and to a time when the symptoms of 
metritis have almost entirely disappeared. The onset is characterised 



INFECTIOUS PSEUDO-RHEUMATISM IN ADULTS. 



101 



by difficulty in rising, and soon afterwards by lameness, or by the animal 
failing to place weight on one of the hind limbs. The affected joint, 
usually one of the articulations of the stifle, appears markedly enlarged, 
is not appreciably hot to the touch, but reveals a certain amount of 




Fig. 54. — The femoro -tibial joint in a case of 
infectious rheumatism. All the articular sur- 
faces of one side have undergone change (the 
condyle of the femur, interarticular cartilage, 
and the upper extremity of the femur). 




Fig. 55.- 
joint. 



-Normal femoro -tibial 



painful sensibility on pressure. The periarticular tissues are infiltrated 
and the synovial sacs slightly distended. 

After a few days, a week or two at most, the periarticular swelling 
diminishes, and the condition appears to remain stationary. 

Appetite is normal or only diminished. The pain continues, and 
causes progressive wasting and diminution in the yield of milk. 

If at this time the practitioner makes a careful digital examination of 
the diseased region, he may find one of two conditions. In the first, the 



102 



RHEUMATISM. 



synovial sacs appear distended, fluctuating and in exactly the same 
condition as in ordinary bog- spavin. This is what has been termed the 
exudative form of infectious arthritis. In the second, the enlarged joint 
remains very sensitive, the walls of the synovial sac are thickened, 
fluctuation is either absent or only slightly marked, but induration is 
very manifest. This constitutes the plastic form. 

Exudative arthritis is the form usually seen at first. It may preserve 




Fig. 56. — Plastic form of infectious rheumatism (pseudo-anchylosis). 



its primary characteristics, but only too often proves to be the fore- 
runner of the plastic form, which develops with the lapse of time. If 
nothing is done wasting becomes more marked, and is accompanied by 
cachexia. The animals are unable to rise, the complications insepar- 
able from decubitus occur, and wasting or secondary purulent infection 
sets in. 

Lesions. In the exudative form the changes are confined to inflam- 



INFECTIOUS PSEUDO-RHEUMATISM IN ADULTS. 103 

mation and thickening of the synovial membranes, intra-articular 
exudation, and sometimes grooving of the cartilages without ulceration 
of the articular surfaces and without disorganisation of the joint. 

The plastic form, on the other hand, leads to destruction of the 
cartilages, ligaments, and sub-cartilaginous bony layers, induration and 
calcification of the walls of the synovial cavity, and even periostitis of the 
ends of the bones, with the formation of false joints. The internal 
surface of the inflamed synovial membranes begins to granulate, the 
fibrous clots distending the articular dilatations are perforated by 
these extending granulations, and fibrous tracts soon develop even 
in the articulation itself, undergo calcification, and produce complete 
anchylosis. 

Diagnosis. The diagnosis is easy. The animal's history and 
symptoms, and the stationary character of the pain in the earlier 
stages are sufficient to prevent any error. 

Prognosis. The prognosis is grave, but not fatal. In the exudative 
form recovery may follow early treatment. In the plastic form, however, 
the chances of success are extremely meagre. 

Treatment. It is easier to prevent than cure, particularly in these 
forms of arthritis. The means are simple, and consist in always 
treating the post-partum infection as soon as it is recognised. The 
animals can be effectively safeguarded against later articular complica- 
tions by the free use of intra-uterine antiseptic injections, until the 
uterine injuries have wholly healed, and by the administration of saline 
purgatives and diuretics. 

When infectious arthritis is diagnosed, it is still necessary to resort 
to the same methods if the uterine sj^mptoms persist, and to complete 
the treatment by local applications. 

The best method of local treatment seems to consist in puncturing 
the articulation aseptically, removing almost all of the liquid exudate, 
and immediately thereafter firing the skin covering the joint in points 
or lines. 

If treatment has been invoked too late, if plastic arthritis with 
the formation of fibrous bands within the joint and destruction of the 
cartilages and calcification of ligaments, etc., already exists, there is no 
economic object in undertaking treatment. Fattening may be attempted, 
or the animals may be handed over to the butcher, if wasting is not too 
far advanced. 

The use of cold douches, plaster bandages, blisters containing nitrate 
of mercury, painting with sulphuric acid, etc., are too inconvenient and 
too inefficient to be recommended in actual practice. Similarly, the 
salicylate of soda, which is so useful in simple rheumatism, has no real 
superiority over diuretics in this condition. 



104 EHEUMATISM. 



SCURVY-SCORBUTUS. 

Definition. " Scurvy is a subacute or chronic trophic disorder 
characterised by debility, inanition, anaemia, swelUng and bleeding of 
the gums, gingival ulceration, dropping of the teeth, and petechial or 
more extensive hsemorrhages and exudations in the skin, serosa, and 
solid tissues." 

Causes. ''Among the lower animals, pigs especially suffer, when 
kept in close, foul quarters and fed on a monotonous and insufficient 
ration. Formerly scurvy . . . was attributed to an exclusive diet of 
salt food ; to excess of sodium and deficiency of potassium salts ; to the 
absence of fresh vegetables ; to tainted food, etc. In pigs the food and en- 
vironment are usually chiefly at fault, the subjects have been kept . . . 
in foul buildings, in a hot, moist atmosphere, and with an uniform diet 
of maize or other unvarying and insufficient ration. Eoll attaches 
great importance to putrid food. Benion has found the affection 
mainly in obese swine, the forced feeding and intestinal fermentations 
manifestly operating as factors. Hess and others attribute the disease 
in pigs to the germ of erysipelas. Stengel has produced purpuric disease 
in animals by inoculation of the extravasated blood from human scurvy 
patients. Miiller and Babes found a slender bacillus and streptococci in 
the tissues of scorbutic gums. . . . There is considerable presumption 
of the existence of a microbian cause, the efficiency of which is dependent 
on the unhygienic conditions above stated, while these unwholesome 
conditions are equally non-pathogenic in the absence of the microbe." 

Lesions. " The blood is black and incoagulable or clots loosely, rigor 
mortis is slight, changes may be found in the number and character of 
the white and red blood globules, but are not constant ; there is usually 
an excess of sodium salts and deficiency of potassium ones, and there is 
marked petechiation of the skin, mucosae and serosae. The bone marrow 
may be abnormally red and the bones fractured at the epiphyses, or 
carious. . . . The gums are softened, swollen, red and uneven, with 
haemorrhagic discoloration, erosions, necrotic areas and ulcers." 

Symptoms. '' Anorexia or fastidious appetite, prostration, debility 
and sluggish, indifferent movements, are followed by the local lesions on 
the skin and gums. On the skin appear petechiae and extravasations, 
which often implicate the bristles, so that they may be shed or pulled 
out with ease, the bulbs appearing dark and bloodstained (bristle rot). 
These may be followed by necrotic sloughs, and deep ulcers that are slow 
to heal. The gums are red and swollen, with haemorrhagic spots, and 
bleed on the slightest touch. Erosions, sores, and ulcers are not 
uncommon ; the tongue is dry and furred, and the mouth exhales a foetid 
odour. The teeth may become loose in their sockets. Swelling of the 



SCURVY — SCORBUTUS. 105 

joints . . . may be noticed, and lameness or stiffness from muscular 
or inter- muscular extravasation. Blood effusions into . . . the eye 
have been noticed, and paralytic or comatose symptoms from similar 
effusions on the brain. In the absence of improvement the patient 
becomes more and more debilitated and exhausted, and death may be 
preceded by profuse exhausting diarrhoea." 

" Prognosis is unfavourable in advanced cases, and when the faulty 
regimen cannot be corrected." 

Treatment. " The first consideration is to correct the unwholesome 
conditions of life, purify the building and its surroundings, and allow a 
free range on pasture. Subject each patient to a thorough soapy wash, 
and if possible allow clean running water in which a bath may be taken 
at will. Access to green food and invertebrates (slugs, larvae, etc.) is 
important, or a varied diet of grain, middlings, bran, roots, fruits, tubers, 
cabbage, silage, etc., must be furnished. Iron and bitters (gentian, nux 
vomica) are useful, and sometimes small doses of arsenite of soda solu- 
tion or cream of tartar are useful. Acorns or horse-chestnuts are 
recommended. For the mouth a wash of potassium chlorate, soda 
biborate, or potassium permanganate may be resorted to. . . .In 
the case of fat pigs it is more profitable to butcher at once, as soon 
as early symptoms appear." From Law's " Veterinary Medicine," 
p. 558, Vol. III. 



SECTION II. 

DISEASES OF THE DIGESTIVE APPARATUS. 

SEMIOLOGY OF THE DIGESTIVE APPARATUS. 

The group of diseases which affect the digestive aparatus is one of 
the most important in bovine pathology, because almost all animals of 
the bovine species are bred with the object of utilising to the full their 
powers of digestion and assimilation. 

Whether we consider adult fat animals, calves intended for slaughter 
or milch cows, the object sought is always the same — i.e., to secure the 
greatest possible economic return through the medium of the digestive 
functions. 

Even although in working oxen there is no tendency to overfeeding, 
the animals remain none the less predisposed to diseases of the digestive 
apparatus ; the meal-times are often too short, and rumination has to be 
performed under the yoke or during work — in a word, under unfavourable 
physiological conditions. 

Semiology. To ensure correct diagnosis it is necessary here, perhaps 
more than in any other department of pathology, to be capable of grasp- 
ing the symptoms or syndromes and signs afforded by the different parts 
of the digestive apparatus ; to know how to co-ordinate and group them 
so as logically to deduce the final synthesis, the diagnosis. The diagnosis 
proving correct, the prognosis becomes easy, and this is the chief object 
from the economic standpoint. The practitioner who undertakes treatment 
knows how to deal with the case, and the owner likewise knows what he 
undertakes to do. 

Although this classification may appear arbitrary, we shall consider 
successively diseases of the mouth, of the pharynx, oesophagus, stomach, 
intestines, etc., firstly describing the symptoms characterising these 
diseases. At the same time we should state that many symptoms are 
common to a large number of diseases and in themselves have absolutely 
nothing characteristic. They are simply sign-posts capable of showing 
the way. 

Mouth. External examination reveals the condition of the muzzle, 
the lips and their commissures, and the surroundings of the buccal 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 



107 



opening, and detects the existence of any desquamation, rents, eruptions, 
ulcerations, etc., which may be present. 

In quiet animals the practitioner can examine the cavity of the mouth 
single-handed, but in troublesome animals it becomes necessary to have 
an assistant, who seizes the muzzle with one hand and the tongue with 
the other, or who simply fixes the animal's head. In exceptional cases 
it will be necessary to secure the patient to a post, tree, or wall. The 
mere attempt at examination will show whether there is trismus or 
absolute freedom of movement in the jaws. 

By introducing the fingers between the commissures and applying 
them to the bars or to the free 
portion of the tongue, the prac- 
titioner will be able approxi- 
mately to estimate the local and 
general temperature. The sen- 
sations experienced will also 
inform him of the degree of 
moisture or dryness of the 
mouth and of its sensibility. 

On separating the jaws, he 
will note the odour exhaled and 
its possible abnormalities — its 
acid, sourish, foetid, or putrid 
character. He will directly ob- 
serve any ansemia or hyper- 
emia of the mucous membrane, 
from the inner surface of the 
lips and cheeks up to the soft 
palate, although owing to the 
thickness of the buccal epithe- 
lium it is not always easy to 

estimate anaemia or hypersemia in the ox. The surface of the tongue 
should also be examined, and a note made whether it appear dry, pasty, 
dusty, sooty, etc., though these appearances are occasionally apt to lead 
one astray. The observer should also inquire regarding want of appetite, 
depraved or exaggerated appetite, etc. 

Even the manner in which the animal picks up its food will serve 
to direct his attention to the development, or possible existence, of some 
disease of the mouth, although want of appetite is not always charac- 
teristic of a lesion in the pharynx or oesophagus, but sometimes of a 
lesion in its neighbourhood, like hypertrophy of the retropharyngeal or 
bronchial l^'Uiphatic glands. 

This examination will also detect the existence on the lips of wounds, 




Fig. 57. — Examination of the mouth. 



108 



DISEASES OF THE DIGESTIVE APPARATUS. 



cuts, injuries or specific eruptions (aphtha, tuberculous ulcerations, the 
ulcerations of gangrenous coryza, etc.) on the gums indications of 
gingivitis, periostitis, mercurial poisoning, actinomycosis of the maxilla, 
and ulcerations of all kinds ; on the tongue, of wounds, of simple or 
specific inflammatory eruptions (aphtha, the ulcerations of actinomycosis, 
tuberculosis, gangrenous coryza, etc.), as well as the swellings due to 
superficial or deep-seated glossitis. By the same method of examination, 
though with somewhat more difficulty, one can detect abnormal mobility, 
irregularity of development, caries, etc., of the teeth, the condition of 
the excretory ducts of the salivary glands, the state of the hard and 

soft palate, and the existence of 
fissures, vegetations, polypi and 
tumours. 

Salivary glands. The salivary 
glands, particularly the parotid and 
submaxillar^^ should be examined 
by direct inspection and palpation. 
Direct inspection reveals the 
existence of swellings, deformity 
of parts, increase in salivation, or 
ptyalism, which sometimes occur 
in conjunction with foot-and- 
mouth disease, actinomycosis, 
acute stomatitis and mercurial 
poisoning, as well as increase in 
size of the salivary ducts. 

Palpation reveals the degree 
of sensibility of the parts, the 
existence of oedema, induration, 
cysts, and, more frequently, distension of the salivary ducts as well as 
the presence of calculi, tumours, the direction of fistulee, etc. 

Difficulties may occur, particularly when the submaxillary and parotid 
glands are affected ; but methodical and complete examination will usually 
enable one to differentiate the conditions. 

Pharynx. The pharnyx may be examined externally by inspection 
and palpation, and internally by direct digital palpation. Inspection 
reveals possible deformities of the region of the gullet, palpation the 
condition of the tissues as well as abnormal sensibility and infiltration. 
Internally, digital examination must be cautiously conducted, and after 
a strong gag has been securely inserted in the mouth. Under such con- 
ditions it is without danger. The hand being inserted exactly in the 
median line will detect obstructions which may already have been partly 
identified by external palpation, as well as the existence of inflammation 




Fig. 58. — Examination of the month. 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 



109 



with or without the formation of false membranes, and of ulcerations, 
polypi, etc. 

(Esophagus. In consequence of its anatomical formation, situation 
and course, the oesophagus may be divided into two distinct parts — viz., 
the cervical, which can be examined from the outside, and the thoracic, 
which cannot so be examined. 

The cervical part may be examined by inspection, by palpation from 
one side, or by palpation with both hands and from both sides. 

Inspection leads to the detection of changes in the shape of the 
oesophagus and of the jugular furrow. In fat subjects, however, it is of 




Fig. 59. — Examination of the pharynx. 



little value. As the position and the course of the oesophagus are known, 
unilateral palpation, or, better still, bilateral palpation, employing both 
hands, is of very much greater service. These methods reveal the 
presence of swellings, infiltrations, changes in shape and sensibility, the 
presence of foreign bodies, the existence of dilatations or contractions 
of the tube, etc. 

Auscultation and percussion, though recommended by some prac- 
titioners, are not of much service. 

Inability to swallow, due to change in the oesophagus, is also detected 
by inspection. Its existence suggests a number of possible conditions, 
such as fissure or ulceration of the oesophagus, compression in the 
mediastinal region as a result of tuberculous or other disease, contraction 
or dilatation of the oesophagus, etc. Furthermore, inspection will betray 



110 DISEASES OF THE DIGESTIVE APPARATUS. 

the existence of dilatation of the tube, to which vomiting and regurgitation 
of food are sometimes due. 

Internal exploration is the only method of detecting changes in the 
thoracic portion, and may also be utilised to locate lesions in the cervical 
region. It is practised by passing a sound of small calibre or any 
flexible cylindrical object, such as a cart rope, etc. The patient must be 
fixed with the head extended on the neck and a proper gag or speculum 
introduced into the mouth. Exploration assists us in recognising the 
existence of inflammation of the oesophagus, true or false contraction, 
dilatation and the presence of obstructions. 

In animals of the bovine species all these lesions — viz., inflammation 
of the oesophagus, fissuring and ulceration, obstructions, compressions, 
dilatations and contractions of the tube — although not very frequent, 
are nevertheless from time to time encountered. 

Stomach. Exploration of the stomach or of the different gastric 
compartments presupposes an exact knowledge of the respective positions 
of the different reservoirs. Topographical anatomy shows that the rumen 
is situated in the left flank, and that it occupies the whole of the left 
abdominal region from the diaphragm to the pelvic cavity. As a con- 
sequence, it may be explored from the region of the twelfth rib ; it is 
inclined slightly from above downwards, and from left to right, its ex- 
treme right border extending as far as, or a little beyond, the white line. 

The reticulum, the smallest of the four reservoirs, is situated in the 
sub-ensiform region at right angles to the median plane of the body. On 
the left it touches the rumen and the diaphragm ; on the right side it 
is in contact in front with the diaphragm, above with the omasum, and 
to the right and towards the rear with the abomasum. The omasum is 
situated above the reticulum and conical right portion of the rumen ; 
in front it touches the liver, and towards the back and left the rumen. 
The abomasum is situated obliquely in the right hypochondriac region, 
its anterior surface resting on the lower wall of the abdomen towards the 
middle and right side of the body, its pyloric portion extending upwards, 
behind the right hypochondriac region. 

Rumen. The rumen can be examined by inspection, palpation, per- 
cussion, and auscultation. The use of the oesophageal sound and of the 
trocar and canula is also of value in diagnosis. 

Inspection affords information of a varying character, according to 
the moment when it is practised, even in a condition of health. It only 
extends to the condition of the flank before or after a meal, etc., empti- 
ness of the rumen being accompanied by hollowness of the flank, and 
distension, following an abundant meal, by fulness in this region. 

When digestion is not proceeding normally, the flank may be distended 
unduly by gaseous accumulations or by the presence of solid food. In 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 



m 



abdominal and mediastinal tuberculosis and in gastro-enteritis there may 
be simple tension or slight dilatation. When indigestion or enteritis is 




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entering on a favourable stage, the flank may appear hollow, and in cases 
of chronic diarrhoea it may appear retracted. 



112 DISEASES OF THE DIGESTIVE APPARATUS. 

Digital examination or palpation may be practised over the entire 
region of the flank. It shows whether the rumen is full or empty, 
reveals the consistence of the contained food in cases of chronic indiges- 
tion, the sensibiUty of the walls, and the rate and order of the muscular 
contractions. Direct or indirect percussion maybe carried out on a hori- 
zontal line from the twelfth rib as far back as the flank, and vertically 
from the lumbar vertebrae to the white line. In health one discovers in 
young animals an upper zone of normal resonance due to gas, a zone of 
semi-dulness and an inferior zone of absolute dulness, due to the liquids 
in the rumen. The spleen, which .is attached to the supero -anterior sur- 
face of the left side of the rumen, does not seriously restrict the area 
open to percussion. 

In pathological conditions percussion from above downwards may pro- 
duce a tympanitic sound, due to gaseous indigestion or a clear sound 
throughout the greater portion of the vertical diameter suggestive of 
acute gastro-enteritis with the formation of gas in the rumen, or of 
adhesive peritonitis preventing the rumen from collapsing. Indigestion 
due to excess of solid food, on the contrary, is characterised by a dull 
sound throughout the entire region from above downwards. Percussion 
along a horizontal line permits of the delimitation of certain zones which 
vary a great deal in area, according to the case. 

Auscultation is more instructive than percussion. Like percussion, it 
may be practised throughout the entire depth of the abdomen, from the 
transverse processes of the lumbar vertebrae as far as the white line, and 
in a horizontal direction from the eleventh rib to the region of the flank. 

Auscultation of the upper zone enables one to detect sounds of 
deglutition, gurgling sounds (glou-giou), and a sound resembling falling 
water, due to the movement of solids or liquids in the rumen and 
reticulum. The sounds heard vary in different cases, and depend on 
the state of repletion or of emptiness of the rumen. 

Auscultation of the middle zone reveals : 

Firstly, a very special crepitation sound, which may be compared to 
the deflagration of a handful of salt thrown on burning coal. It is 
believed to result from the bursting of bubbles in the contents of the 
rumen under the action of normal digestion. 

Secondly, a churning sound produced by the rhythmic peristaltic 
contractions of the rumen, by which the substances ingested are very 
intimately mixed. By applying the ear over the flank region or by 
palpation the rhythmic contractions of the rumen, two per minute in 
most cases, can readily be perceived. 

In practice examination of the rumen is confined to these four methods. 

Puncture. From an exclusively scientific point of view, exploration of 
the rumen also comprises analysis of the gas collected through puncture 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 113 

and analysis of the liquids removed by aspiration (first stages of gastric 
digestion). Normally, these gases, in the order of their abmidance in the 
mixtm-e, consist of the following : Carbonic acid, carburetted hydrogen 
and nitrogen. 

In disease, and in most cases of abnormal fermentation, the carbu- 
retted hydrogen is greatly in excess of the carbonic acid. In chronic 
gastro-enteritis, ammonium sulphide and other offensive gases are found 
in addition. 

Chemical analysis. In the rumen the ingested food is macerated in 
an alkaline liquid at a temperature of 100° to 101° Fahr. (the alkalinity 
is due to the saliva) . This process markedly modifies the composition of 
the ingested matter. Nevertheless, the upper portion in contact with the 
gas sometimes presents a slightly acid reaction, probably due to carbonic 
acid. The sugary and fatty materials contained in the food respectively 
undergo lactic and butyric fermentation. Only a small quantity of the 
starch, however, is transferred into sugar. In the calf, and in very young 
animals, the reaction of the rumen is acid throughout the entire period 
of sucking. In disease, when rumination has long been suspended and 
chronic loss of appetite or gastro-enteritis exists, the reaction is generally 
acid. The sugars, gums, and soluble salts of forage, roots, etc., are dis- 
solved in the rumen, but fatty materials undergo no modification. 

The reticulum, which is the smallest of the gastric compartments, is 
situated in the sub-ensiform and retro-diaphragmatic regions, extending 
right and left of the middle line to a nearly equal distance. Above and 
to the left it communicates freely with the rumen, to the right with the 
omasum. 

In practice it can only be examined in two ways : inspection and 
palpation. 

By inspection changes in the configuration of the ensiform region 
may sometimes be detected. Such changes are rare, and must be dis- 
tinguished from congenital deformity. They sometimes accompany 
inflammation of the reticulum produced by a foreign body, when the 
lower abdominal wall is directly perforated by such body. 

In cases of inflammation of the reticulum due to foreign bodies, 
abscess formation, perforation, etc., it is possible to detect oedematous 
infiltration, abnormal sensibility, fluctuation and increased heat, etc., by 
manipulating the parts with the fingers or the clenched fist. 

If the evidence pointing to the presence of a foreign body in the 
reticulum is considered sufficient, gastrotomy may be performed and the 
interior of the viscus examined with the hand, but although the operation 
is possible it is very rarely practised. 

Omasum. The omasum occupies, so to speak, a position inverse to that 

D.C. I 



114 DISEASES OF THE DIGESTIVE APPARATUS. 

of the reticulum, lying deep down on the right side, behind the diaphragm, 
under the hypochondrium, and above the abomasum and reticulum:. 

It is the only gastric compartment which cannot be examined, although 
when impacted it may be felt on the right side. 

Abomasum. The abomasum is lodged in the lower part of the right 
flank under the circle of the hypochondrium. It extends obliquely from 
below, upwards from the sub-ensiform to the sub-lumbar region. The 
smaller curvature is turned towards the rumen on the left side ; the larger 
curvature is in contact with the abdominal wall. In spite of what has so 
often been stated by those who have never seen it, the abomasum can be 
examined and is accessible along the circle of the hypochondrium. 

In adults useful information can rarely be obtained by inspection; 
but in sucking calves the abomasum, if distended by indigestion, gastro- 
enteritis, etc., sometimes appears prominently in the right abdominal 
region. Palpation with the fingers or with the fist will detect exag- 
gerated sensibilty, irritation, inflammation, or distension. 

Percussion and auscultation furnish no very precise information. The 
information obtained by the above-described examination of the stomach 
is in practice amplified by a search for certain symptoms which are usually 
easy to detect. They comprise : 

(a) Suppression or irregularity of rumination. This very important 
symptom suggests the degree of gravity of the digestive disturbance, and 
to some extent the gravity of the general condition. Suppressed rumina- 
tion is a common symptom in many diseases, some of which are purely 
digestive, though all are not. It is, however, a grave sign in most cases. 

(b) Eructation, which is usually frequent, may be regarded as normal 
provided the exhaled gas preserves the fresh odour of grass or of the food 
swallowed, like brewers' grains, turnips, etc. Sometimes the gas is sour, 
acid, foetid, or putrid, all of which conditions indicate disease. 

(c) Yawning is not common. It becomes frequent and attracts 
attention in certain abnormal conditions ; in others, again, it may be 
completely suppressed. 

(d) Nausea and vomiting are rare. Vomiting is commoner in calves, 
and results from inability to digest the milk, or simply to over-distension 
of the abomasum. The matter vomited by adults usually consists of 
partly masticated food, and is derived from the rumen ; while the con- 
tents of the abomasum are occasionally rejected, in which case the 
material is of pulpy consistence and has an acid smell. 

(e) Digestive disturbance is sometimes accompanied by various modi- 
fications in the breathing, such as immobilisation of the hypochondriac 
region and of the diaphragm ; abnormal sensibility and reflex coughing 
on palpation, and, in inflammation of the reticulum due to foreign 
bodies, costal respiration. 



SEMIOLOGY OF THE DIGESTIVE ArPARATUS, 



115 



Vcd 



h 




Vc.o 



Gi 



Fig 61.-Position of the abdominal viscera, seen from below. Gi, large intestine; 
J^^rrt: A ^"""t °i *^^ rumen; E, E, epiploon (line of insertion) ; P, pamich or 
rumen, A j, xyphoid appendix of the sternum ; E, reticulum ; C,abomasum; Y.c.d., 
right pouch of the rumen ; Ig, small intestine. 

I 2 



116 DISEASES OF THE DIGESTIVE APPARATUS. 

It is by methodically observing, grouping, and classifying the 
symptoms presented that one is enabled to detect the links connecting 
them. 

Intestine. The intestinal mass is contained in the right half of the 
abdomen above the compartment of the stomach. The large intestine 
occupies the upper zone, corresponding externally with the hollow of 
the flank from the thirteenth rib to the haunch. The small intestine 
occupies the middle zone from the thirteenth rib to the entrance to the 
pelvis and the stifle region ; the inferior zone is occupied by the rumen 
and abomasum, and in pregnant females by the gravid uterus. 

Notwithstanding these indications it is somewhat diflicult to examine 
the mass of the large intestine, separated as it is from the abdominal wall 
by the U-shaped inflection of the duodenal loop, of which the deep retro- 
grade branch is in contact with the terminal portion of the floating colon. 

Inspection of the right flank furnishes no information of value 
in diseases of the intestine, nor is auscultation of much service beyond 
enabling one to detect the frequency, diminution, or absence of bor- 
borygmus. Palpation alone is really of service. Practised gently and 
superficially with the tips of the fingers it detects abnormal sensibiHty 
in acute cases of enteritis ; when with more energy, palpation reveals 
whether the bowel be full or empty, provided that the muscular resis- 
tance be not too marked. 

Colic. In colic the clinical signs, their varieties, and the lesions which 
give rise to them are of much more importance. When it results from 
intestinal congestion a frigore (due, for example, to the ingestion of cold 
water), colic is usually violent, sudden, and of relatively short duration. 
In other cases it is violent and prolonged for several hours, a whole day, 
or even two days, and may be followed by coma and suppressed peristalsis ; 
it then indicates invagination, volvulus, or strangulation. Sometimes, on 
the contrary, it remains dull and is slow and continued (acute gastro- 
enteritis, hsemorrhagic gastro-enteritis, etc.). 

Finally, colic of the latter character may, in addition, be accompanied 
by icterus, in cases of retention of bile, biliary calculi, hepatitis, etc. 

Anus. Examination of the anus is easy. Simple inspection reveals 
its presence or absence, and consequently the existence of congenital 
rectal atresia, which is somewhat common in calves and colts. Digital 
exploration is, however, sometimes useful, for in occasional cases an anus 
may exist, which externally appears normal, but terminates in a sac, the 
rectum being closed by a membranous partition. 

Nothing is easier to recognise than tenesmus ; it occurs in cases of 
profuse diarrhoea, diarrhoea of calves, and dysentery in newly-born 
animals. 

Rectal exploration. Exploration of the rectum is a last and most 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 



117 



valuable means of confirming the diagnosis in all visceral diseases of the 



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pelvis and abdomen. To utilise this method to the full, the rectal pouch 



118 DISEASES OF THE DIGESTIVE APPARATUS. 

should first be thoroughly emptied by the free use of enemata, the 
subsequent examination being made with great care. The animal's hind 
legs being secured, the operator smears his hand and forearm with some 
fatty substance, and, forming the fingers into a cone, introduces them 
with gentle pressure through the anus, the palm of the hand being turned 
downwards. Passing the hand gently along the rectum, the operator 
will be able to distinguish the conical posterior pouches of the rumen, 
the loop of the duodenum, the mass of convolutions of the small intes- 
tines and of the colon, etc. Next, he will examine the vagina, uterus, 
bladder, ureters, kidneys, aorta, and the pelvic and sub-lumbar lymphatic 
glands. He may be able to recognise distension of the rumen with food, 
twists of the intestine, hernise, mesenteric or diaphragmatic invagination 
or volvulus of the bowel, etc. 

In other cases he may be able to discover lesions of the kidney, of the 
uterus, of the broad uterine ligaments, of the ovaries, or of vessels. 

In all cases it is desirable to make a methodical and complete 
examination, whatever the primary object may have been. Such 
an examination may be carried out as follows : The operator having 
introduced his hand into the rectum, begins by examining the state 
of the pelvic organs, the rectum, base of the vagina, the body and 
horns of the uterus, the bladder and the lymphatic glands and ligaments 
of the pelvis. 

By laying the hand flat in the rectum and pressing gently downwards 
the anterior border of the pubis may be felt, somewhat more deeply 
placed. The rectum is then thrust slightly to the right, and the 
ascending branch of the right ilium, as high as the sacro-iliac articula- 
tion, and the lower surface of the sacrum, are directly examined ; lastly, 
the hand is directed towards the left, gliding down the left ilium, and 
returning to the point of departure. In this way the state of the pelvic 
floor, of the arteries, veins, and lymphatic glands, etc., the degree of 
mobility, tension, or fulness of the uterus, as well as the condition of the 
broad ligaments, are all ascertained. 

Still more deeply placed, and at the extreme limit to which the arm 
can be introduced, will be found some or all of the above-mentioned 
organs — viz., the small intestine, large intestine, kidney, etc. 

Defsecation : Examination of the faecal material. The character of 
the faeces is very important in certain diseases ; e.g., diarrhoea assumes a 
varying importance, according as the discharges are of an alimentary, 
serous, mucous, or sanguinolent type, and are slight, temporary, intense, 
profuse, or continued. In other cases defsecation is slow, becomes diffi- 
cult, and various degrees of constipation exist. Defsecation may be 
completely suppressed, as in invagination or strangulation of the intes- 
tines ; on the other hand, one may observe diarrhoea, dysentery (microbic 



SEMIOLOGY OF THE DIGESTIVE APPARATUS. 119 

or sporozoic diarrhoea), and intestinal haemorrhage. The last-named may 
be of varying degrees of acuteness, from the passage of simple drops or 
streaks of blood, distributed over almost normal excreta, to the passage 
of michanged blood in liquid jets or in clots. 

Macroscopic examination. Macroscopic examination takes cognis- 
ance, firstly, of the quantity (40 to 80 lbs.), consistence (firmness or soft- 
ness), colour (olive green, blackish green, greyish black, sooty, or tarry) 
and odour (normal, foetid, putrid, etc.) of the faeces. 

Sometimes the excreta are moulded and covered with glairy mucus, 
or contain such abnormal products as undigested food (a sign of 
chronic diarrhoea), false membranes, false membranes due to pseudo- 
membranous enteritis, fibrinous clots, or parasites like liver flukes, taeniae 
and strongyles. 

Microscopic examination. Microscopic and bacteriological examina- 
tion is sometimes useful ; and even when macroscopic examination has 
revealed nothing, it is possible to detect the presence of the eggs of 
parasites like flukes, strongyles, hooked worms, etc., the presence of 
sporozoa (as in intestinal coccidiosis) and of specific microbes, as in the 
diarrhoea of calves, etc. 

It is only by the synthesis of methodically collected signs that 
one finally succeeds in exactly diagnosing the numerous diseases which 
may affect the intestine : intestinal congestion, invagination, volvulus, 
intestinal strangulation (mesenteric or diaphragmatic herniae, etc.), 
atresia of the anus, acute or haemorrhagic enteritis, or intestinal 
helminthiasis. 

Liver. The liver is situated in the right sub-lumbar region. It is 
fixed behind the diaphragm and under the hypochondriac region, and 
extends from the ninth to the thirteenth rib. It can be examined by 
palpation through the last intercostal spaces and behind the thirteenth 
rib. In health it is difficult to pass the fingers sufficiently under the 
hypochondriac circle to reach the liver ; but in case of morbid hyper- 
trophy it extends more or less beyond the last rib, and palpation be- 
tween the last ribs sometimes reveals abnormal sensibility. 

Percussion better than palpation enables one to delimit the space 
occupied by the liver, particularly towards the back, where there is no 
interposed layer of lung. • Percussion is especially useful in detecting 
hypertrophy due to cancer, tuberculosis, echinococcosis of the liver, etc., 
or hepatic atrophy. In isolated cases icterus may exist, confirming the 
conclusions otherwise arrived at. 

Pancreas. The pancreas is situated rather deeply in the right sub- 
lumbar region, below the kidney, behind the liver, above the floating 
colon, and within the duodenal loop. It is therefore very difiicult to 
examine ; moreover, the diseases which affect it are still little understood. 



120 DISEASES OF THE DIGESTIVE APPARATUS. 

The point most prominently brought forward by this demonstration 
of the topographical anatomy and semiology of the digestive apparatus 
is the difficulty of accurately diagnosing digestive diseases in the ox when 
one confines oneself to a superficial examination. To have any chance 
of arriving at an exact diagnosis, methodical and thorough examination 
is indispensable. Given this condition, accurate diagnosis becomes 
possible, despite all difficulties. 



CHAPTER I. 

DISEASES OF THE MOUTH. 

STOMATITIS, 

Definition. By stomatitis we mean inflammation of the buccal 
mucous membrane. Stomatitis may be simple — i.e., due to accidental 
causes, to varying local forms of irritation, or to wounds ; or, on the 
contrary, it may be specific, of infectious origin, like the stomatitis 
of foot-and-mouth disease, gangrenous coryza, cattle plague, etc.; 
or, finally, it may be of toxic origin, like the stomatitis of mercurial 
poisoning. 

Here we shall only study the simple forms of stomatitis, the 
gangrenous stomatitis of calves, and mercural stomatitis. The others 
will be noticed in speaking of the diseases of which they form one of 
the symptoms. 

SIMPLE STOMATITIS. 

Causation. Simple stomatitis of bovine animals is often due to 
feeding with rough forage, or forage containing prickly or spiny plants, 
like thistles, sea holly, eryngo, etc. Sometimes it follows prolonged 
irritation by rough teeth, premolars or stumps, or accompanies the shed- 
ding of the temporary molars. Ingestion of irritant plants like nettles, 
certain specimens of the orders Lahiatce and JJmhellifevcE, leaves 
covered with vesicant insects, cabbage and turnip leaves infested with 
aphides, oil beetles, etc., or the swallowing of hot liquids, may also, 
though more rarely, produce it. Finally, in grave diseases of the diges- 
tive apparatus, the buccal mucous membrane may secondarily become 
affected. 

Symptoms. The primary symptoms are usually represented by 
ptyalism and a certain difficulty in grasping food. In other cases the 
mucous membrane appears slightly dry for some time before salivation 
sets in. On introducing the fingers into the animal's mouth some 
elevation of temperature may be noted, and on direct inspection the 
non-pigmented regions are seen to be abnormally vascular, a fact which 



122 DISEASES OF THE MOUTH. 

has earned for this form of stomatitis the names of " erythematous " 
and " erysipelatous stomatitis." 

If the stomatitis is due to local multiple irritation, such as results 
from spines and prickles in the food, the abnormal vascular appearance 
is confined to the neighbourhood of the abrasions or punctures, and the 
affected regions are of very varying size. In some cases, principally as a 
consequence of trifling local irritation and of burns of the first and 
second degree, blisters of varying size may develop and break, leaving 
behind ulcerations, which, however, always heal rapidly. The aphthous 
non-contagious stomatitis mentioned by certain authors seems most 
probably to pertain to this class. 

Diagnosis. The diagnosis is usually easy, and a little attention to 
the accompanying symptoms is sufficient to avoid confusion with the 
various forms of symptomatic stomatitis. 

The prognosis is favourable. 

Treatment is based on removal of the determining cause, if this can 
be recognised, withdrawal of rough forage, removal of sharp points on 
the teeth, extraction of stumps, etc. As a rule, recovery follows rapidly. 
It can be hastened by washing out the mouth directly, or by means of a 
syringe, with water containing honey, vinegar, decoctions of brier twigs, 
oak bark, barley or rice. This treatment is completed by supplying 
nourishing gruel and food demanding little mastication. 

CATAEEHAL STOMATITIS IN SHEEP. 

" The more delicate buccal mucosa in these animals would render 
them more subject to inflammations, but this is more than counter- 
balanced by the mode of prehension of aliments, not by the tongue, but 
by the delicately-sensitive lips, and further by the daintiness and care 
with which these animals select their food. The treatment would not 
differ materially from that prescribed for the ox." (Law's ''Veterinary 
Medicine," Vol. II. p. 15.) 

[The treatment referred to consists of simple astringent and anti- 
septic washes, borax given in the drinking water, or mixed with honey 
or treacle and smeared occasionally on the tongue. Washes of sodii 
hyposulphis or sulphis, or even weak solution of carbolic acid, may be 
used after the irritant cause has been removed. Vinegar or diluted 
mineral acids may be used alternately with decoctions of blackberry bark 
or other vegetable astringents. When there are symptoms of gastric 
disorder a laxative, followed by vegetable bitters and other tonics, may 
be prescribed. Foreign bodies — thorns, wire, etc. — fixed in the tongue, 
cheek, or palate should be searched for and removed at the first 
examination of the patient.] 



NECROSING STOMATITIS IN CALVES. 123 



NECROSING STOMATITIS IN CALYGS. 



Definition. This name is applied to a special stomatitis, which in very 
yomig animals produces superficial necrosis of more or less extensive 
areas of the buccal mucous membrane, and sometimes of subjacent parts. 

The disease, although somewhat rare in France, has been mentioned 
by Lafosse and well studied by Damman and Lengien. 

Causation. Its cause is still imperfectly understood. Some regard it as 
a consequence of insufficient nourishment, of disturbance resulting from 
dentition, of general exhaustion, and of bad hygienic conditions. These 
explanations are scarcely sufficient, however, and at the present time 
there is a tendency to regard it as a complication of primary grave, . 
debilitating diseases, Hke the diarrhoea of calves, omphalitis, omphalo- 
phlebitis, etc. Moussu has never seen it apart from omphalitis, and 
he considers the lesions due to the action of the bacillus of necrosis. 
Infection occurs through the umbilicus becoming soiled by contact with 
the litter. 

The early symptoms consist in loss of appetite, congestion of the 
mucous membranes, and salivation. Early examination of the buccal 
cavity reveals the presence everywhere, except on the palate, of whitish- 
grey or yellowish patches, whose aspect is markedly in contrast with that 
of neighbouring parts. These are fragments of the mucous membrane 
undergoing necrosis. They are numerous, are surrounded by a narrow 
inflamed zone, and may be from J inch to 1 inch in diameter. 

Necrosis advances rapidly, and extends throughout the thickness of 
the mucous membrane ; the slough soon becomes delimited and separates. 
The odour of the mouth is then absolutely foetid, and the saliva appears 
streaked with pus and blood. 

The ulcerations exhibit a livid base, and show no tendency to heal. 
Necrosis extends in depth, and affects the muscles, tendons, and even the 
periosteum and the bones. The teeth are frequently loosened. 

Grave complications, such as pharyngitis, broncho-pneumonia, infec- 
tious enteritis, and septicaemia soon appear, and the animals are carried 
off by septic infection and intoxication in a few days — at the longest 
in a week. 

Diagnosis. The diagnosis is only difficult at first ; and, at a later 
stage, the only mistake possible is that of confounding the condition with 
a very grave attack of aphthous stomatitis. Local sanitary conditions 
are sufficient to secure the avoidance of this error. 

Prognosis. The prognosis is extremely grave ; the disease usually 
results in death ; recovery is exceptional. Very luckily the disease seems 
to become rare in direct proportion as the hygienic conditions of cattle 
breeding and keeping are improved. 



124 • DISEASES OF THE MOUTH. 

Treatment. Curative treatment always appears to be ineffectual 
when a grave primary disease has already enfeebled the animal before 
necrosing stomatitis appears. In those cases where the stomatitis con- 
stitutes the primary condition, attempts should be made as far as possible 
to cleanse the wounds. The buccal cavity should be thoroughly washed 
out, and the wounds then cauterised with solution of carbolic acid of 
6 per cent, strength, nitric acid of 10 per cent, strength, hydrochloric 
acid of 7 to 8 per cent, strength, or chromic acid of 20 per cent, 
strength. 

This local cauterisation is performed with a tampon of cotton wool 
fixed to a handle ; for necessarily it is impossible to apply any dressing 
whatever of a permanent nature. The cauterisations may be repeated 
twice a day. The stump of the umbilical cord should never be forgotten, 
for it sometimes contains a mass of necrotic tissue the size of a man's 
thumb. It should be thoroughly cleansed and the wound plugged with 
a mixture of iodoform and boric acid. 

This treatment will not avail unless the functions are stimulated by 
rich food that can be easily masticated and digested, and by giving milk 
of good quality, or boiled milk, eggs, meat-powder, cooked beans, etc. 
Aromatic infusions and hay tea containing coffee and small quantities 
of alchohol or tincture of quinine are also of service. 

MYCOTIC STOMATITIS IN CALVES. 

Thrush. Mug net. 

"This is a form of stomatitis manifested by a raised white patch on the 
mucous membrane and determined by the presence of the Oidium albicans 
{Saccharomyces albicans), a cryptogam discovered by Berg in 1842 in 
thrush in children. It is closely allied to the mucor, and attacks only the 
young and feeble. The white crust consists of epithelial cells intermingled 
with an abundance of the white mycelium and oval spores of the fungus. 
Andry in his artificial cultures found that it was pearly white when grown 
on gelatine, dirty white on potato, and snow white on carrot." 

Symptoms. '' Buccal mucosa, red, congested and tender, shows here 
and there white curdy looking elevations, or red erosions caused by the 
detachment of such masses. These bear a strong resemblance to the 
crusts seen on this mucosa in rinderpest, but are easily distinguished 
by the absence of the attendant fever, and by the discovery, under the 
microscope, of the specific microphyte. The eruption may extend to the 
pharynx and oesophagus and interfere fatally with deglutition, but usually 
it merely renders sacking painful and is not serious." 

Treatment. Cleanse and disinfect the sheds, " and invigorate the young 
animals by sunshine, free air and exercise. Locally . . . borax, which 



ULCERATIVE STOMATITIS IN SHEEP. 125 

arrests the gTO^Yth of the parasite, whether m artificial cultures or in the 
mouth. The powder may be rubbed into the sores, or it may be mixed 
with . . . molasses and used as an electuary. As substitutes boric 
acid, salol, thj^mol, potash chlorate, or Condy's fluid may be used." 
(Law's ''Veterinary Medicine," Vol. II. p. 36.) 

ULCERATIVE STOMATITIS IN SHEEP. 

The name of ulcerative stomatitis of sheep has been given to a disease 
which is characterised by the appearance of a pultaceous deposit on the 
surface of the buccal mucous membrane and later by the development of 
ulcerations and of vegetative growths. 

Causation. The cause is imperfectly understood. In certain years 
the disease appears to attack lambs at the time of weaning, but it may 
also aft'ect flocks of animals as old as fifteen or eighteen months, two 
years, or even more. It is contagious, and may extend to one-half or two- 
thirds of the entire number in the flock. Full-grown and old animals 
appear to be immune. 

It was formerly thought, a priori, and in consequence of the character 
of the buccal deposit, that the disease was identical with thrush, and that 
the lesions were produced by Oidium albicans. Neumann in 1885 declared, 
however, that he could not find the fungus in question in scrapings from 
the mucous membrane. 

Moussu had similar negative results in the experiments he made 
during 1894, when he examined both young and old animals belong- 
ing to flocks in the departments of Berry and of La Brie. 

In addition it has been suggested that the disease affects badly cared- 
for and badly fed lambs, and subjects suffering from ''watery cachexia." 
This seems correct in many cases, and Moussu has seen ulcerative 
stomatitis decimate flocks which had previously been attacked with 
intestinal helminthiasis and verminous broncho-pneumonia ; but, on the 
other hand, in the environs of Melun he saw it in animals which had 
previously been quite free of disease and were kept under perfect hygienic 
conditions. 

The conditions in which animals are reared, the use of common drink- 
ing ponds, and the method of supplying flocks with food, are the chief 
causes of the distri-bution of the disease. 

Symptoms. The symptoms consist in loss of appetite, or rather in 
difficulty in grasping and masticating food, wasting, a certain degree of 
dulness, and salivation. Somewhat later one often sees appear on the 
free margin of the upper and lower lips an eruption of small vesico- 
pustules, which quickly become covered with yellowish-brown crusts and 
bleed on the slightest touch. The lips swell, become sensitive and pain- 
ful, so that examination of the cavity of the mouth should be made with 



126 . DISEASES OF THE MOUTH. 

care. The mucous membrane is then seen to present a very varying 
number of greyish- white or greyish-brown points, each of which is due to 
the destruction of the epitheHum and to the production of a pultaceous 
deposit, which can very readily be removed, leaving uncovered superficial 
ulcerations, which bleed if very lightly touched. These ulcerations are 
of irregular shape, and are distributed most freely over the gums, the 
internal surface of the lips and cheeks. The palate and tongae are only 
invaded in the last stages. Still later one notes, instead of these ulcera- 
tions and as a consequence of abnormalities in the process of repair, 
reddish violet turgid vegetations varying in size from that of a millet 
seed to that of a pepper-corn or even of a small mulberry. 

The total duration of the disease varies with its degree of intensity. 
In favourable cases it may not exceed eight to ten days ; in grave cases 
it continues for fifteen to twenty days. Kecovery is usual when the 
subjects are vigorous and well-nourished lambs, or well-kept sheep, 
previously free of disease. On the other hand, Moussu has noted a mor- 
tality of 15 to 20 per cent, in thin animals of bad bodily condition and 
already depressed by verminous broncho-pneumonia and intestinal hel- 
minthiasis. When the attack is about to prove fatal, complications such 
as gastro-enteritis, resulting from septic infection or intoxication, and 
accompanied by foetid diarrhoea, often make their appearance. 

Diagnosis. The diagnosis presents no difficulty, the characteristics of 
this stomatitis being entirely different from those of the aphthous form. 
The claws are never affected, and there is no lameness. 

Prognosis. In this connection the practitioner will do wisely to avoid 
committing himself, and to closely study the conditions under which the 
disease has developed. In all cases the appearance of foetid diarrhoea 
must be regarded as of very unfavourable augury. 

Treatment. The first precaution to take consists in separating all 
the healthy animals in the flock, and placing them in a non-contaminated 
spot. 

The diseased are then treated one by one ; each day the buccal cavity 
is washed out with boiled water or wdth a solution of borax or boric acid. 
After each washing the ulcerations should be touched with tincture of 
iodine or with some other rather active antiseptic solution. Finally it 
might be useful, and would be of value, to add to the gruel or water a 
small quantity of common salt and of salicylate of soda at the rate of 
15 grains to the pint. 

GENERAL CATARRHAL STOMATITIS IN SWINE. 

Causes. " Swine suffer from simple stomatitis w^hen exposed to 
thermal, mechanical, or chemical irritants. Such irritants comprise food 
that is too hot, or is hard and fibrous, or which contains spikes and awns, 



GENERAL CATARRHAL STOMATITIS IN SWINE. 127 

capable of entering and irritating gland ducts or sores, or food which is 
fermented or putrid, food or medicine of an irritant character. The habit 
of catching and holding swine with a running noose over the upper jaw, 
and the forcing of the jaws apart with a piece of wood in search of the 
Cysticercus cellalosa are further causes. In several specific infectious 
diseases inflammation of the mucous membrane, with eruption or erosion, 
is not uncommon. This aphthous fever is marked by vesicular eruption' 
muguet by epithelial proliferation and desquamation, hog cholera and 
swine plague by circumscribed spots of necrosis and erosion. Patches of 
false membrane are not unknown, and local anthrax, tubercle, and acti- 
nomycosis are to be met with. Inflammation may start from decaving 
teeth." -^ ^ 

" Symptoms resemble those in other animals, refusal of food, or a dis- 
position to eat sparingly, to select soft or Hquid aliments, to swallow hard 
materials half chewed, or to drop them, to champ the jaws, and to seek 
cold water. Accumulation of froth around the lips is often seen and 
the mouth is red, angry, dry, and hot, and exhales a bad odour." 

-Treatment does not differ materially from that adopted in other 
animals : Coolmg, astringent, antiseptic lotions, honey and vinegar and 
m case of spongy or eroded mucosa, tincture of myrrh daily or oftener 
Soft feedmg, gruels, pulped roots, ... and clean water should be 
constantly within reach. In case of . . . indigestion a laxative, 
followed by vegetable tonics, will be in order." (Law's ''Veterinary 
Medicine," Vol. II. p. 17.) '^ 

ULCERATIVE STOMATITIS IN SWINE. 

" This is the scorbutus of Friedberger and Frohner, the glossanthrax 
of Bemon. 

Causes. "It has been attributed to insuificient or irritant food, to 
damp, close pens, and to chronic debilitating diseases, and all these 
act as predisposnig causes. In gastritis and in infectious fevers like 
hog cholera, swine plague, and rouget (hog erysipelas) the spots of con- 
gestion and petechias on the buccal mucous membrane may become the 
starting points for ulcerative inflammations. These conditions appear 
however, to be supplemented by infection from bacteria present in the 
mouth or introduced in food and water, and, as in the case of other 
domestic animals, the most successful treatment partakes largely of dis- 
infectant applications." 

Symptoms. "Loss of appetite, grinding of the teeth, champing of 
the jaws the formation of froth round the lips, fcetor of the breath, red- 
ness of the gums and tongue, and the formation of vesicles, or white 
patches, which fall off, leaving red, angry sores. These may extend, 
forming deep unhealthy ulcers, with increasing salivation and fcetor. 



128 DISEASES OF THE MOUTH. 

As the disease advances the initial dulness and prostration become more 
profound, and debihty and emaciation advance rapidly. Unless there is 
early improvement an infective pharyngitis or enteritis sets in, mani- 
festly determined by the swallowing of virulent matters from the 
mouth, and swelling, redness, and tenderness of the throat, or colics 
and offensive black diarrhoea, hasten a fatal issue. Eachitis may be 
a prominent complication, as it seems in some instances to be a pre- 
disposing cause." 

Treatment. '' Isolate the healthy from the diseased, and apply dis- 
infection to all exposed articles and places. Employ local antiseptics as 
in other animals. Sulphuric or hydrochloric acids, in fifty times their 
volume of water, or tincture of iron, chlorate of potash, or chloride of 
ammonia, or borax have been used successfully. Bitters and aromatics 
have also been strongly recommended." (Law's "Veterinary Medicine," 
Vol. II. p. 29.) 

MERCURIAL STOMATITIS. 

This form of stomatitis possesses certain distinguishing characters, 
and develops after severe or trifling mercurial poisoning. 

Causation. Sheep sometimes suffer from mercurial poisoning as a 
result of the use of baths containing corrosive sublimate or mercurial 
ointment for acariasis or other cutaneous parasitism. Animals of the 
bovine species seem predisposed to the disease as a consequence of their 
special sensitiveness to the action of mercury, which is not shared by 
other species. 

Mercurial poisoning may occur accidentally, but is usually the result 
of some attempt at treatment. Any preparation containing mercury or 
mercurial salts may produce it. In domesticated animals it most fre- 
quently results from the action of the ordinary mercurial blister or 
mercurial ointment of the pharmacopoeia, or again of calomel. Sometimes 
it follows the use of mercurial salts in uterine douches, or in lotions used 
to wash out large abscess cavities or wounds. 

The application of blisters or of antiparasitic dressings, or infriction 
with grey ointment over extensive surfaces, favours this intoxication. It 
may result from direct local intra-cutaneous absorption, from vapour given 
off by mercurial applications obtaining entrance into the body through 
the broncho-pulmonary and digestive tracts, from vapour given off by 
metallic mercury (as in ships' holds), or from ingestion of mercurial 
compounds licked off' the skin, as certainly occurs. Hitherto in all dis- 
cussions, even the most recent, on the mechanism of poisoning, partisans 
of different views do not appear to have given sufficient attention to these 
now clearly proved facts. The conclusion to be drawn is that in animals of 
the bovine species mercurial preparations ought to be used with caution. 



MERCURIAL STOMATITIS. 129 

and that even under such conditions stomatitis may appear. Finally, it 
should be remembered that all lesions of the kidney indicated by albumi- 
nuria and other signs, and all lesions of the liver, favour poisoning by 
checking or preventing the elimination of mercury by the kidney, or by 
interfering with its transformation in the hepatic cells. 

Nature. Kegarding the essential nature of stomatitis, it would appear 
(according to the work carried out in 1890 by Gallipe on mercurial stoma- 
titis in man), that we should regard it as a septic stomatitis, and not as a 
primary toxic stomatitis. The mercury absorbed by the body not only 
produces salivation, but a very important change in the chemical compo- 
sition of the saliva. The vitality and toxicity of the saprophytic microbes 
normally present in the buccal cavity appear greatly to increase, and 
although only the most trifling erosions may exist in the mucous mem- 
brane, true intra-mucous inoculation takes place, and forms the point of 
origin for septic stomatitis. 

It has been found that it is not even necessary to have lesions in the 
buccal mucous membrane ; in fact, this is the weak point in the theory 
emitted. Nor is a modification in the chemical composition of the saliva 
sufficient ; for when a mixture of iodine and the iodides, for example, is 
being given, the saliva is chemically modified, and yet stomatitis, properly 
so-called, does not occur. 

What seems most probable is that mercurial stomatitis is a toxi- 
infectious stomatitis, in the development of w^hich mercury acts primarily 
by its toxic effect on the salivary glands, whose secretion it modifies, and 
on the buccal epithelium, the renewal of which it checks. Infection of 
the mucous membrane is thereby favoured, even in the absence of any 
previous lesion, and stomatitis develops. 

Symptoms. The symptoms consist in abundant salivation with 
discharge from the mouth, suggesting the existence of foot-and-mouth 
disease. In grave cases the saliva appears streaked with blood, even 
from the beginning. The buccal cavity exhales an intense foetid odour 
which, during the following days, becomes more marked ; the mucous 
membrane is pale in colour, and coated with a greyish exudate. The 
mouth is hot and sensitive, the gums are swollen, reddish- violet in 
colour, and painful. Alveolar periostitis soon sets in, the teeth become 
loose, and mastication is rendered impossible, especially as the inflam- 
mation causes the tongue to swell and lose its mobility. These 
symptoms are unaccompanied by fever. 

In the last stage ulcerations and local necroses appear on the gums, 
on the inner surface of the lips and cheeks, and around the commissures 
of the lips. The patients are almost unable to feed, rapidly lose flesh, 
become ansemic, and die from septic infection. The temperature is often 
below normal. 

D.c. K 



130 DISEASES OF THE MOUTH. 

A toxi-infectious gastro-enteritis, with foetid, blood-stained diarrhoea, 
is grafted on the primary stomatitis. Comphcations in connection 
with the respiratory, circulatory, and urinary apparatus appear, and 
the patients die in a condition of absolute exhaustion. 

Naturally this termination is not inevitable ; trifling cases of poisoning, 
and even grave forms, when properly treated, may, and should, recover. 

Diagnosis. The diagnosis is mainly based on the history, except in 
cases of accidental and unsuspected poisoning. 

Prognosis. The prognosis is grave, for even when the disease does 
not prove fatal the animals remain anaemic and exhausted for long 
periods. 

Treatment should principally be directed towards combatting the 
local complications. When poisoning is due to external applications 
of mercury or its salts the skin should be washed with soap and water, 
and afterwards dressed with a soluble sulphide, which renders the mer- 
cury insoluble. The mouth should frequently be rinsed with boiled water, 
with decoctions of barley or marsh-mallow, with a 30 per cent, solution of 
boric acid or alum, or with a 1 to 2 per cent, solution of salicylic acid. 

Fully grown cattle receive daily doses of IJ to 2 drams of chlorate 
of potash internally. This drug appears to owe its favourable action 
to the fact that it is partly eliminated by the salivary glands. Lastly, 
with the idea (which may, perhaps, be illusory) of minimising and 
checking the bad effects of the mercury introduced into the body, certain 
practitioners have recommended the administration of eggs, flowers of 
sulphur {2^ to 5 drams), sulphate of iron (IJ to 2^ drams), and of iodide 
of potassium (IJ to 2 J drams), drugs which are alleged to form insoluble 
compounds with mercury. 

GLOSSITIS. 

The term " glossitis " is applied to all inflammations of the tongue, 
whether superficial or deep seated. These inflammations may result 
from trifling causes, in which case they are termed " simple, acute, 
or chronic golossites " ; or, on the other hand, from well-recognised 
causes, like tuberculosis or actinomycosis, in which case they receive 
the name of " specific giossites." Here only ordinary glossites -are 
investigated, the others being more particularly described in chapters 
specially reserved for the description of the primary diseases of which 
these form symptoms. 

SUPERFICIAL GLOSSITIS. 

This condition is characterised by lesions in the mucous membrane 
or in the immediately subjacent tissues, deeper seated structures not 
being involved. 



ACUTE DEEP-SEATED GLOSSITIS. 131 

The causes are similar to those of simple stomatitis, and as in animals 
of the bovine species the tongue is the principal and almost the only 
organ of prehension, it is particularly exposed to the chance of injury. 

As mechanical injury done by rough fodder first makes its effects 
felt on the tongue, superficial glossitis is often due to the action of sharp 
or prickly plants like farze, wrest-harrow, thistles, sea-holly, etc. The 
glumes, awns, and spikelets on certain plants play a similar part. 

Caustic medicinal draughts, hot duinks, and sharp points on the 
molar teeth may also produce the disease without the rest of the buccal 
mucous membrane being involved. 

Symptoms. These are extremely simple. There is, first of all, some 
difficulty in grasping the food and some diminution of appetite, which, 
however, is more apparent than real, the digestive organs acting well. 
The second symptom consists in moderate salivation without special 
characters. 

The local symptoms alone are characteristic. The mucous membrane 
covering the tongue appears red, swollen, locally inflamed, and painful. 
The inflamed areas are usually located on the free part near the frsenum 
or opposite the molar teeth. 

Thorns, foreign bodies, awns or spikelets of rough grasses can often 
be seen implanted in the tongue, and if the disease has existed for a 
short time, little ulcerations may not improbably be discovered. 

Diagnosis. The characteristics of this superficial glossitis are suffi- 
ciently marked to allow of easy diagnosis, and to prevent it being 
confused with the lesions of actinomycosis , or tuberculosis or with the 
extensive desquamation w^hich accompanies foot-and-mouth disease. 

Prognosis. The prognosis is never grave. Recovery occurs in six 
to eight days, provided the primary cause be removed. 

Treatment consists in avoiding the use of rough food, in removing 
foreign bodies implanted in the mucous membrane or in rasping rough 
and irregular teeth. For the rest, as in stomatitis, mere attention to 
cleanliness suffices. The mouth is w^ashed out with boiled water, boric 
acid solution, mixtures of vinegar and water, or with water containing a 
small percentage of alcohol. 



ACUTE DEEP-SEITED GLOSSITIS. 

This disease has also been termed parenchymatous and interstitial 
glossitis, because all the deep-seated tissues, including the muscles and 
connective tissue layers are involved in the inflanniiation. 

Causes. The disease may be due to a neglected attack of super- 
ficial glossitis, to some grave microbic infection, or to excoriation and 
ulceration of the mucous membrane. Very often it is of traumatic 

K 2 



132 DISEASES OF THE MOUTH. 

origin, and is due to violent traction on the tongue by. herdsmen or 
others when administering draughts of their own composition. This 
traction causes rupture of the muscle and slight interstitial hsemorrhage. 

The symptoms develop somew^hat rapidly. Whilst at first the animal 
shows difficulty in grasping food, it is soon totally incapable of doing so. 
The tongue loses its mobility, is no longer protruded from the mouth, and 
swallowdng becomes so painful that salivation sets in. On direct exami- 
nation the tongue is found sw^ollen, thickened, immobile, painful, and 
occupying the whole of the oral cavity, sometimes projecting beyond the 
region of the incisors, and preventing the mouth being closed. Inflam- 
mation may become so intense that the point of the tongue hangs out of 
the mouth. It becomes blackish, bleeding, swollen, and excoriated by 
contact with foreign bodies or simply w^ith the row of incisor teeth. 
The saliva becomes foetid, blood-stained and purulent, and contains large 
quantities of broken down epithelial cells. It is not uncommon to note 
more or less extensive necrosis. 

Diagnosis. The diagnosis of this form of glossitis presents no 
difficulty, for if under certain conditions it may resemble, for example, 
the glossitis of actinomycosis, it differs essentially from that disease by 
its rapidity of development, by its complications, and also by the absence 
of the specific ray fungus. 

Prognosis. The prognosis is grave, not only on account of the 
possible complications, but also because the animals are unable to feed 
and therefore lose flesh with very great rapidity. 

Treatment. The first steps in treatment are in the nature of local 
disinfection, in order to prevent general infection. The mouth therefore 
should be washed out five or six times per day wdth boiled water, follow^ed 
by antiseptic injections until improvement commences. Solutions of 
boric acid or borax (3 per cent.), chlorate of potassium (2 to 3 per cent.), 
or salicylic acid (3 to 4 per cent.), are useful, but the free employment of 
1, 2, or 3 per cent, solutions of chloral is even preferable. 

With the idea of protecting the organ from external injury, Lafosse 
formerly suggested the use of a suspensory bandage for the tongue, fixed 
to the base of the horns by small bandages. Guittard recommends 
scarification of the free part, and the application of a support perforated 
at the bottom to allow the blood, saliva, pus, etc., to escape. In spite of 
careful attention the disease may last from two to three weeks. 



CHRONIC GLOSSITIS. 

This form of disease has also been termed " sclerosing glossitis " and 
" non-actinomycotic wooden tongue," because it is anatomically charac- 
terised by induration of the tissues, and because apparently it resembles 



CHRONIC GLOSSITIS. 133 

true " wooden tongue,'-' with which it was confused until within the last 
few years. Imminger in 1888 and Pflug in 1891 described two forms. 
The first, termed " superficial sclerosing glossitis," is said to be the 
more frequent, and most commonly affects young animals suffering from 
irregularities in dentition. It seems due to a superficial acute glossitis 
assuming a chronic form. The submucous connective tissue in time 
undergoes hj^perplastic changes, so that the tongue at first becomes 
swollen and afterwards absolutely rigid. One never finds ulcerations or 
actinomyces. 

Diagnosis. A close examination will always enable the case to be 
diagnosed at the first visit, or under any circumstances after a short 
time. 

The prognosis is very grave, because the animal has the greatest 
difficulty in grasping and masticating food, or may even be unable to do 
so. Patients lose flesh very rapidly, and end by dying of hunger. 

Treatment is of little service. The administration of iodine, the 
only drug which appears indicated, has proved of very questionable 
value. Economically, it is better to slaughter the animal. 



The second variety is rare, and has been termed " deep-seated 
sclerosing glossitis." It is simply a chronic form of ordinary deep- 
seated glossitis. The layers of connective tissue separating the muscles 
are represented by very hard, inelastic vertical partitions. As a con- 
sequence, the W'hole tongue becomes indurated and more or less com- 
pletely immobile. In this condition, again, there is neither ulceration 
nor actinomyces. 

Diagnosis. The diagnosis necessitates a careful examination. In 
the living animal it is very difficult to establish a distinction between 
this and the preceding form, though after death the task becomes much 
easier. 

The prognosis is grave, complete restoration of the parts being 
impossible. 

The treatment differs in no respect from that given in the preceding 
instance. It is of little value. 



Imminger and Pflug have also described a deep-seated nodular scleros- 
ing glossitis, characterised anatomically by the existence in the depth of 
the tongue of fibrous nodules, varying in size between a small nut and 
a fowl's egg. The tongue is only slightly increased in size. 

This disease may perhaps be due to actinomycosis. 



CHAPTER 11. 

DISEASES OF THE SALIVARY GLANDS, TONSILS 
AND PHARYNX, 

PAROTIDITIS (PAROTITIS). 

The term " parotiditis " indicates an inflammatory condition of the 
parotid gland. Of this disease several forms exist. The disease is termed 
simple when due to accidental causes or infections, specific when result- 
ing from some special disease germ like the ray fungus. Anatomically, 
these diseases consist in inflammation of the glandular parenchyma and 
connective tissue stroma which surrounds the acini. 

ACUTE PAROTIDITIS. 

Causation. The causes of acute parotiditis are varied. Mechanical 
violence or contusions (due to collisions with fixed bodies, horn thrusts, 
or blows from the ox-goad) may produce it, the glandular parenchyma 
and connective tissue separating the acini or the peri-glandular tissue 
being torn, crushed, lacerated, and often also directly infected in conse- 
quence of the injury. Ascending infection through the medium of the 
salivary ducts represents a second possible cause of the disease. 

Finally, parotiditis may, in some cases, constitute only a localisation 
of a general disease. It seems a fact that in rare circumstances paro- 
tiditis may assume an epizootic character, and attack a large number of 
animals in a particular stable or in neighbouring stables ; and if, under 
these circumstances, we are unable to blame the food (which has not been 
done), we are forced to admit the influence of infection and contagion. 

Symptoms. Whatever the cause, the symptoms are generally w^ell 
marked. In many cases the first indication of the disease is apparent 
or real want of appetite, always complicated with difficulty in swallowing, 
and often accompanied by trifling fever. 

Salivation, resulting from irritation of the gland and inability to 
swallow, becomes abundant, and at once draws attention to the buccal 
cavity and adjacent parts. Inspection of the patient then reveals the 
existence in the parotid region of a diffuse swelling, which on palpa- 
tion is found to be hot and painful, and to occupy the whole of 




ACUTE PAROTIDITIS. 135 

the parotid region between the lower jaw and the upper extremity of 
the neck. The lesion is usually unilateral, but occasionally bilateral. 

Parotiditis may terminate in resolution, suppuration, or necrosis. 
The suppuration may either be simply subcutaneous and extra-glan- 
dular, or may involve a portion of the salivary gland and of the parotid 
lymphatic gland in addition. 

Necrosis is exceptional, though Moussu saw double and total gangrene 
of both parotids, complicated with septicaemia, in the animal, of which a 
sketch is given herew^ith. 

If the disease is due to violent injury by a foreign body, traces of a 
wound may be found, but it 
is often useless to search for 
these, even when the parts 
have been pricked with a 
sharp goad. When the in- 
flammation has resulted from 
ascending infection of the 
salivary ducts, exaggerated 
sensibility may sometimes 
be detected throughout the 
whole length of Stenon's 
duct, particularly at the point 
where the duct crosses the 
jaw. There is always marked ^-....^ — -- 

difficulty in moving the head, X 

particularly towards the side, : , /' 

and sometimes in a vertical '.# 

plane. The head is extended ■i 

on the neck, and is held stiffiy Fig. 63.— Acute parotiditis. 

in such a way as to suggest 

the possibility of tetanus. Some observers have described as an impor- 
tant symptom marked swelling of the orifice of Stenon's duct. It is cer- 
tainly difficult to detect, and furthermore is of no great significance. 

Diagnosis. Although diagnosis is easy, it is a difficult matter to 
detect the point of origin of the disease. The salivation and difficulty 
in swallowing might seem to suggest pharyngitis, a condition which 
sometimes exists simultaneously. The distinction between this disease 
and the forms of chronic parotiditis, or tumour formation in the parotid 
(due to actinomycosis, lymphadenoma, melanoma), is also easy, on ac- 
count of the slow development of the last-named conditions. The only 
condition liable to be confused with that under consideration is abscess 
of the sub-parotid gland. 

Prognosis. The gravity of the disease varies greatly. Whgn 




136 DISEASES OF THE SALIVARY GLANDS, TONSILS AND PHARYNX. 

inflammation is slight, resolution usually occurs in eight to fifteen days. 
The onset of suppuration is announced by renewal of the fever, by more 
marked swelling, which becomes localised at a given point, and by the 
existence of deep or superficial fluctuation. Care, however, is required 
to detect the last named. 

Necrosis may occur suddenly when the infecting organism is specially 
virulent, and may affect one- third, one-half, or the whole of the gland. 
•The prognosis then becomes extremely grave, and if diagnosis has not 
been prompt and treatment energetic, death may follow in a short time 
from septic infection. 

Treatment. Unless some well-marked sign foreshadows a compli- 
cation, treatment should be directed to ensuring resolution. Bleeding 
has been recommended ; its good effects, however, are open to doubt, 
though one cannot entirely forbid it. All practitioners agree in recog- 
nising the value of vesicant applications. The affected parts may be 
freely dressed with an ointment containing 2 per cent, each of pulverised 
tartar emetic and bichromate of potash, with the ordinary cantharides 
blister, or even with a w^eak mercurial blister, provided that the animals 
can be prevented from licking the w^ound. 

Some practitioners prefer vesicants prepared wdth cantharides and 
croton oil. Whatever be the vesicant chosen, it is best after three or 
four days to apply emollients of slightly antiseptic character, such as 
ointments containing camphor, boric acid, salol, etc. When abscess 
formation is recognised the abscess should be opened as early as possible. 
Some precautions are necessary to avoid injuring important nerves and 
vessels ; in dealing with a deep-seated abscess it is necessary to use the 
knife for dividing the skin alone, to seek the abscess by blunt dissection 
with the finger or wdth round-pointed scissors, and to open it with a 
similar instrument. The cavity should then be freely washed out with a 
warm antiseptic solution — 3 per cent, carbolic solution, or 1 per cent, 
iodine solution, etc. If necessary a drain composed of iodoform gauze 
can be inserted, or a counter-opening made. 

In the case of partial necrosis, all the necrotic tissue must be carefully 
removed, injury to vessels, which w^ould favour septicaemic infection, being 
avoided. Afterwards free antiseptic irrigation should be employed several 
times per day. 

In necrosis of the entire parotid extirpation may seem indicated ; but 
the greatest prudence is demanded, for the operation is extremely serious 
and delicate. 

CHRONIC PAROTIDITIS — PAROTID FISTULA. 

When a case of acute parotiditis is not treated, and does not end 
in suppuration, it is usually succeeded by chronic inflammation and fibrous 



INFLAMMATION OF THE SUBMAXILLARY GLAND. 137 

induration of the gland. Any obstruction of Stenon's duct, whatever the 
originating cause (foreign bodies like wheat awns, oat grains, calculi, etc.) 
stops the flow of saliva throughout the excretory apparatus, and produces 
over the entire parotid region a doughy swelling, which might seem to 
indicate the existence of indolent parotiditis. The collections of liquid 
thus produced have improperly been termed " salivary abscesses." If 
ascending infection fails to occur, or if infection is unimportant and does 
not lead to suppuration, a relatively painless chronic parotiditis develops, 
and in this case movements of the head and mastication and deglutition 
alone are impeded. 

The salivary ducts, however, may become so distended that the main 
superficial collecting duct undergoes softening, and the skin covering it 
becomes ulcerated, just as would occur had a true abscess formed. 
Under such circumstances the skin soon yields and a salivary fistula is 
established. 

The symptoms consist in swelling or induration of the gland, inter- 
ference with movement of the head and with mastication ; the whole 
developing slowly without pain or fever. 

The distinction of this condition from actinomycosis of the parotid 
may sometimes present some difficulty until a fistula develops. 

The prognosis is grave, because there is no hope of normal condi- 
tions being restored. 

Treatment. Treatment often proves unsuccessful. Should the 
condition have resulted from an obstruction, it is first necessary to 
attempt the removal of such obstruction, whether it be a foreign body 
or calculus, and so to re-establish the normal channel for the saliva. 
Local stimulation may be tried, though in cases of fistula without much 
hope of success. Smart blistering of the parts surrounding the opening 
and firing in points have been recommended ; but rather than persist in 
prolonged treatment of doubtful value, it is often better to prepare the 
animals for slaughter. 



INFLAMMATION OF THE SUBMAXILLARY SALIVARY GLAND, 

Inflammation of the submaxillary gland is rare in the ox. As in the 
horse, it is usually caused by the penetration of foreign bodies, such as 
glumes or awns of grain, fragments of straw, thorns, etc., into Wharton's 
duct. 

The difficulty in grasping food and the restricted movement of the 
tongue are the first symptoms to attract attention. On examination, 
the region of the " barbs," usually on one side, appears injected, sw^ollen, 
inflamed, and sensitive. 

The submaxillary space is effaced by the swelling of Wharton's duct ; 



138 DISEASES OF THE SALIVARY GLANDS, TONSILS AND PHARYNX. 

the corresponding submaxillary gland is doughy and 23ainful on pres- 
sure. The symptoms rarely become more threatening than this. 

The diagnosis presents no difficulty. 

The prognosis is favourable. 

Treatment consists primarily in removing the obstruction from the 
duct. Steady pressure from behind, forwards along the course of the 
duct, may sometimes cause the foreign body to be ejected into the mouth, 
along with a jet of offensive saliva. The distended and inflamed duct 
soon becomes emptied, and all the symptoms rapidly diminish. In other 
cases, when the obstructing body is firmly fixed in position, it is necessary 
to open the duct within the mouth by a stroke of the bistoury. 

TONSILITIS IN PIGS. 

"Acute and chronic forms are seen. The former has the general 
causes and symptoms of pharyngitis — fever, dulness, a disposition to lie 
with head extended and buried in litter, drooping ears, watery eyes, 
indifferent appetite, painful deglutition, and sometimes vomiting. Mouth 
red and hot, breath foetid, tonsils swollen, their alveoli filled with muco- 
purulent matter or wdth foetid cheese-like masses. Cough at first dry 
and hard, later loose and gurgling. 

In chronic form there is general swelling of the tonsils wdtli 
distension of follicles by above-mentioned putty-like masses, which are 
often calcareous. These are due to the proliferation of microbes, which 
find in these alveoli a most favourable field for their propagation. The 
affection usually ends in recovery, but may go on to grave local ulceration 
and general infection. 

Treatment. Astringent antiseptics to buccal mucous membrane. 
Electuaries of honey or treacle and borax, sal ammoniac, chlorate or 
permanganate of potash and externally stimulating embrocations to the 
skin of the throat. In some cases solutions of iron chloride or tinc- 
ture of iodine may be used with advantage and as a wash for the mouth 
and fauces. Attend to general health. If constipated give Glauber's 
salt or jalap, . . . and elimination through the kidneys must be 
sought through the use of nitrate of potash or other diuretic." (Law's 
" Veterinary Medicine," Vol. II. p. 46.) 

PHARYNGITIS. 

Inflammation of the mucous membrane of the pharynx is less frequent 
in the ox than in the horse, a fact probably due to its less sensitive 
character in the ox and to differences in the methods of working oxen. 

Causation. The causes are numerous and varied ; and although 
local microbic infection undoubtedly plays the most effective part in the 
development of the disease, it is none the less certain that external 



PHARYNGITIS. 139 

influences are of considerable importance. For this reason chills, 
sudden variations in temperature, sudden arrest of perspiration, and 
currents of cold air have always been invoked as causes. Cruzel thinks 
that the ingestion of ice-cold water in winter is sufficient to produce 
acute i^haryngitis. The action of rough forage may of itself explain the 
development of pharyngitis in animals constantly kept indoors under 
excellent hygienic conditions. In such cases the disease maybe regarded 
as of traumatic origin. Furthermore, it is necessary to mention direct 
injuries of the mucous membrane caused by clumsy examination, 
awkwardness in passing the probang, and attemjDts on the animal's part 
to swallow sharp foreign bodies, which scratch, tear, lacerate, or 
penetrate the mucous membrane and become fixed in it. 

Finally, another series of causes, and not the least important, 
remains to be considered — viz., the forced administration of irritant 
substances like ammonia, tincture of iodine, oil of turpentine, very hot 
liquids, etc. 

To sum up, the four great series of causes consist in direct irritation, 
intra-pharyngeal wounds, variations in temperature, or primary or 
secondary microbic infections. 

The symptoms are characteristic. They consist in loss of appetite, 
difficulty in swallowing, consequent on the condition of the pharynx, and 
fever, which is often marked from the first. Pharyngeal dysphagia can 
easily be distingTiished from that due to injury of the oesophagus, 
inasmuch as it occurs on the first attempt to swallow. 

Urged on by hunger, the animal grasps food, which it chews and 
attempts to swallow, but immediatel}^ allows it to fall back into the 
manger, or ejects it by a painful coughing effort. In the case of liquids, 
even of lukewarm drinks, the same accident occurs, the food or liquid being 
returned by the nostrils. Slight salivation results from this difficulty in 
swallowing. The animal's attitude is similar to that in parotiditis. The 
head is held stiffly, extended on the neck, in order to avoid compressing 
the region of the pharynx, and can only be moved slowly and with much 
pain. There is no apparent swelling of the parotid region, but on 
manipulating or pressing on the gullet the animal sometimes manifests 
the very acute tenderness of the parts by coughing and endeavouring to 
thrust away or to kick the examiner. Finally, examination of the mouth 
sometimes shows reddening and excessive sensibility of the soft palate 
and of the pillars of the fauces. 

These symptoms often assume a more alarming character, or are com- 
plicated by others ; in fact, the condition very rarely stops at pharyngitis, 
but is usually accompanied by inflammation of the larynx, of the soft 
palate, and of the naso-pharynx. The wdiole throat is then inflamed ; 
the nose and sometimes the eyes discharge, and there is difficulty in 



140 DISEASES OF THE SALIVARY GLANDS, TONSILS AND PHARYNX. 

swallo^Yino•, interference with respiration or noisy respiration, and intense 
fever. 

Diagnosis. The diagnosis presents no difficulty, the symptoms men- 
tioned being easy to identify, whether the condition be simply inflam- 
mation of the pharynx or be of a more extensive character. Never- 
theless, cases occur where the symptoms are alarming, but in which 
one might hesitate between the diagnosis of ordinary acute sore throat 
and the sore throat which ushers in gangrenous coryza. A definite 
expression of opinion must then be deferred to a later date ; for one 
cannot be absolutely certain whether or not the other signs of gan- 
grenous coryza will appear. 

When there is only difficulty in swallowing one might a priori sus- 
pect traumatic injury of the mucous membrane, with or without the 
presence of a foreign body. It is also necessary to bear in mind the 
possibility of difficulty in swallowing being occasioned by reflex irritation 
without local lesions, originating in enlargement of the retropharyngeal 
lymphatic glands as a consequence of tuberculosis or other disease. 

The prognosis is favourable ; even without .treatment acute pharyn- 
gitis usually tends to recovery in eight to twelve days, and rarely becomes 
complicated. Nevertheless, some reserve ought to be exhibited in cases of 
pharyngitis due to the action of rough forage, the removal of the cause being 
here indispensable to any improvement. Similarly in cases of pharyngitis 
due to foreign bodies having penetrated the mucous membrane, which 
are chiefly characterised by inability to swallow, the disease may continue 
for a very much longer time than above indicated, unless the foreign 
body is discovered and removed. Inflammation is limited to a zone sur- 
rounding the point of implantation. It extends more deeply with move- 
ments of the foreign body, and may end in the formation of an abscess. 
Of this variety is Hopsomer's remarkable case, in which a darning- 
needle finally obtained exit through the submaxillary space, in which it 
had caused the formation of an abscess. 

Treatment. The treatment is the same whether we are dealing with 
a simple acute pharyngitis or with a more widely distributed inflamma- 
tion. It consists in smartly stimulating the region of the throat with 
mustard, cantharides oil, or ointment, or with an ointment containing 
2 per cent, of tartar emetic and of bichromate of potash, and then cover- 
ing the parts with a flannel hood. This mode of treatment seems 
preferable to that recommended by German authors — viz., the applica- 
tion of cold compresses to the throat, the administration of cold gargles, 
etc. Moderate bleeding, to the extent of two or three quarts, has the 
great advantage, as in all similar cases, of low^ering the temperature. 

This treatment may, if necessary, be completed by the internal 
administration of 3 to 5 drams of Kerme's mineral (oxy sulphur et of 



PSEUDO-MEMBRANOUS PHARYNGITIS IN CATTLE. 141 

antimony) in electuary, according to the animal's size. Medicated 
inhalations diminish local irritation, render swelling less painful, and 
facilitate the separation of false membranes and the discharge of 
adherent mucous secretions. 

The ordinary food should be replaced by cooked roots, luke^Yarm 
drinks and gruels, all rough fodder being prohibited. 

If difficulty in s\Yallowing alone continues, the operator should 
examine the mucous membrane of the pharyngeal cavity with the hand, 
in order to discover and remove any foreign body which may have 
become implanted there. 

PSEUDO-MEMBRANOUS PHARYNGITIS IN CATTLE. 

In addition to the above acute forms of pharyngitis, a pseudo-mem- 
branous, croupal, or pseudo-diphtheritic pharyngitis has been described in 
the ox. It is due to polymicrobic infection, and is characterised by the 
formation of false membranes on the pharyngeal mucous membrane. 
The condition seems to be a pharyngitis of exceptional intensity, vary- 
ing markedly from the classic type and being most nearly related to 
severe sore throat, laryngitis, gangrenous coryza, etc. 

It rarely attacks aged cattle, but is readily transmissible to calves and 
young stock. Cadeac failed to inoculate it on guinea-pigs and rabbits. 
Damman succeeded with sheep and with rabbits, the latter dying in 
twenty-four hours after inoculation with haemorrhage at the seat of 
puncture. Loffier hypodermically infected mice and produced extensiY^e 
infiltration of the abdominal walls, and often of the peritoneum, surface 
of the liver, kidneys and intestine, on which formed a thick yellowish 
exudate containing the organism. 

Causes. Loffier found filaments of a long delicate bacillus about half 
the thickness of the bacillus of malignant oedema. The bacillus did not 
grow in nutrient gelatine or in sheep's blood serum, but readily grew in 
blood serum of the calf. Cadeac gives as predisposing causes : sudden 
chills, rapid alterations of temperature, inhalation of irritant vapours, sup- 
pression of cutaneous secretion, swallowing irritant liquids, and injuries. 

Symptoms. The nasal membrane is reddened, thickened and covered 
in patches with false membrane, causing snuffling and wheezing breathing. 
The throat is tender and swollen, cough is frequent, gurgling, and followed 
by expulsion of false membrane, muco-pus and some blood. Shreds of 
false membrane adhere to the nose and lips. Other symptoms are : fever, 
accelerated pulse, dark mucous membranes, haggard countenance, mouth 
open, hanging tongue, stringy salivation, and constipation or diarrhoea. 

The disease runs a rapid course, and death may occur in twenty-four 
hours. Kecovery may be equally rapid, but often convalescence is 
protracted. 



142 DISEASES OF THE SALIVARY GLANDS, TONSlLS AND PHARYNX. 

Lesions. Intense congestion of mucosae of nose, mouth, pharynx, 
larynx, and bronchi, with here and there j)atches of false membrane, 
which may be soft or tough, according to the duration of the attack. 
The deep surface of the false membranes is blood-stained ; and, according 
to Preitsch, false membranes sometimes occur in the oesophagus, rumen, 
and omasum, which in consequence may show patches of ulceration. 

Treatment (as for the horse). This includes poultices, counter-irri- 
tants, laxatives, febrifuges, alkalies and antiseptics. Inhalations of medi- 
cated vapour, warm water to which has been added some antiseptic — 
carbolic, lysol, creolin, camphor, sulphurous acid ; or for calves, iodoform, 
oil of turpentine, calcium sulphide, silver nitrate, coal tar. To detach 
the false membi'anes ipecacuanha and potash chlorate, or soda sulphate, 
or magnesia sulphate may be tried. Papayin and pepsin have been 
suggested as appropriate remedies. Anyodnes — digitalis, belladonna, 
morphia and aconite — may be useful. Tracheotomy is indicated as a 
last resort. 

PSEUDO-MEMBRANOUS PHARYNGITIS IN SHEEP. 

Eoclie-Lubin states that this is common in flocks as a result of moving 
the sheep in dusty enclosures. The dust is supposed to excite the intense 
croupous inflammation of the mucous membrane. The disease has been 
noticed in spring in young lambs shortly after weaning. Damman 
states that he transmitted the disease .to" the sheep from the exudate of 
the calf. 

Symptoms. Frothy salivation with constant movements of the jaws, 
viscid nasal discharge, difficult deglutition, panting, snuffling breathing, 
throat swollen and very tender, frequent cough, discharge of exudate. The 
head and neck are extended, the eyes dull, appetite is lost, the mucous 
membranes are red or cyanotic, and the animal appears weak and listless. 
As respiration becomes more difficult the mouth is held open, the tongue 
is protruded, and with each cough shreds of false membrane are expelled. 
Death from suffocation is not uncommon. 

The lesions are not different from those seen in the calf. 

The treatment is similar to that for the calf. Tepid drinks con- 
taining hydrochloric acid, or sulphate of soda (1 lb. to 50 sheep) in the 
drinking water, has been recommended. Fumigation with sulphurous 
acid or chlorine may be tried. Small numbers may be treated by swab- 
bing the throat with solution of sodii hyposulphis or weak caustics and 
antiseptics. 



In young and in adult pigs pseudo-membranous pharyngitis is often 
only a manifestation of pneumo-enteritis. It therefore calls for no special 



tHAHYNGEAL POLYPI. 143 

description at this point. No exact investigation of the organisms which 
produce these forms of pharyngitis with false membrane formation has 
been made in veterinary surgery. We only know that these diseases are 
not true diphtheria due to " Klebs' bacillus." Treatment should be very 
energetic from the commencement, but otherwise it differs in no respect 
from that ordinarily adopted. 

Tonics and stimulants, like alcohol, wine, coffee, etc., are indicated. 

[The following account of the disease is summarised from Law's 
" Veterinary Medicine," Vol. II.] 

" Pseudo-membranous pharjmgitis has long been recognised as a 
contagious disease of swine, attacking especially sw'ine kept in herds 
or in close, insanitary pens. Young pigs are more liable to attack than 
older animals, perhaps, owing to the older animals having suffered the 
disease in early life. 

Modern observation shows that pharyngitis with false membranes 
is common in swine plague, and the present tendency is to refer all 
such cases to that category. It is, however, altogether probable that 
the occurrence of local irritation, with the addition of an irritant or septic 
microbe altogether distinct from that of swine plague or hog cholera, 
gives rise at times to this exudative angina. Certain it is that septic 
poisoning with the food is not at all uncommon in the hog, in the absence 
of these infectious diseases. 

Symptoms are those of sore throat, with much prostration, a croaking 
cough, yellow discharge from nose and mouth, and marked muscular 
weakness. The tongue, tonsils and soft palate are red, swollen, and 
studded with patches of false membrane. The identification of swine 
plague may be made by the history of the outbreak, the number of 
animals affected, the tendency to pulmonary inflammation, the enlarged 
lymph glands, the presence of the non-motile bacillus, which does not 
generate gas in saccharine media, and which readily kills rabbits and 
pigs with pure cultures of the germ. 

Treatment. Isolation, cleansing and disinfection. Locally antiseptics 
and generally a febrifuge regimen will be advisable." 

PHARYNGEAL POLYPI. 

The term "pharyngeal polypi" includes tumours of varying 
character, which affect the polypus form, and occur with considerable 
frequency in the bovine species. Many of these polypi are simply actino- 
mycotic grow^ths sj)ringing from the pillars of the fauces, from the 
upper parts of the palate or from its posterior surface. Less frequently 
they arise from the lateral walls or the free surface of the hard palate. 

Symptoms. The symptoms are so characteristic that the diagnosis 
rarely presents much difficulty. They may shortly be described as 



144 DJSEASES OF THE SALIVAKY GLANDS, TONSILS AND P^ARY^NX. 

indicative of repeated obstruction in the pharyngeal, oesophageal or 
laryngeal region. At the moment of deglutition, the polypus is thrust 
towards and obstructs the oesophageal orifice. 

Eeflex stimuli are thus excited, which prevent deglutition ; an attack of 
coughing occurs, and food mixed with saliva is ejected from the mouth 
and nostrils. The attack of coughing displaces the polypus either 
in a forward or lateral direction, and swallowing then again becomes 
possible, until by changing its jDOsition the growth produces fresh signs 
of obstruction. 

In other cases the polypus may only be of such small size as to 
impede the food passing through the pharynx on its way into the 
oesophagus or to cause difficulty in respiration by partially blocking 
the pharyngeal portion of the nasal cavities. In such cases deglutition 
is only checked and rendered slower. 

Or again, the pedicle of the polypus may be sufficiently long to allow 
the growth at certain moments to fall in front of the laryngeal opening. 
Eespiration is then painful, difficult and noisy. Unless the growth is 
displaced during the subsequent attack of coughing, asphyxia may appear 
imminent, or may even occur unless assistance is afforded. 

Guided by these symptoms, the operator will explore the pharynx 
manually, and thus discover the position and size of the tumour. 
Tumours of the naso-pharynx produce very similar symptoms. 

The prognosis is based on the information obtained by manually 
exploring the pharynx. It is relatively favourable if the polypus has a 
well-marked neck, but is very grave if the tumour is largely sessile and 
cannot be removed. 

Treatment. Medical treatment appears useless except in cases of 
polypi due to the presence of actinomyces. The administration of iodine 
and iodide of potassium, in large doses, may then lead to resorption ; but 
extirpation is often preferable. 

In other cases extirpation is the only rational treatment. The 
operation necessitates the performance of provisional tracheotomy in 
order to avoid risk of asphyxia. The growth may be directly removed 
through the buccal cavity without incision, provided that it prove pos- 
sible to pass the chain of an ecraseur around the pedicle ; or through the 
buccal cavity, with incision, after vertically or obliquely dividing the soft 
palate ; or, lastly, through the larynx, after performing median laryn- 
gotomy, thus obtaining access to the pharynx. 

Only the first method of intervention is to be recommended ; the last 
two are more delicate. They necessitate after-treatment, and when the 
patients are in a condition for slaughter it is frequently preferable to 
send them to the butcher. The essential point is not to act without a 
full knowledge of the causes. 



CHAPTER III. 

DISEASES OF THE (ESOPHAGUS* 

The oesophageal tube is of very simple anatomical construction, and 
performs an equally simple physiological function ; nevertheless, in the 
ox it is liable to a large number of diseased conditions. These con- 
ditions may affect only a circumscribed area of the 
mucous membrane or the entire extent of the tube. ,.--^ ~^- ^ 

Again, both the muscular and mucous tissues may f' -^'C-^ K 
be affected, as in inflammation of the oesophagus I '-^ ^^- ' j 
accompanied or followed by contraction, and in the \ ' ^ J 

formation of oesophageal abscesses and tumours ; ' — "'^ 

or the muscular tissue alone may be affected, as Fig. 64.— Schema il- 
in cases of dilatation. Even where no lesion is lustratmg anatomy 

of the oesophagus : 
strong external 



a 



apparent the normal rhythm of deglutition may 

be interfered with, either by the presence of a layer of mnscle, in. 

foreign body (obstruction) or by spasm of the mus- termediate celMo^ 

cular layers (oesophagismus) or by compression due elastic layer, inner 

to tissues surrounding the oesophagus (false con- \^^^&^ of mucous 

tractions) . fXs aX^,^^^^^^^ of 

We shall successively study the different forms , t d'l t t* 
of oesophagitis, contraction, and dilatation, together 

with their complications ; then obstructions, ruptures of the oesophagus, 
oesophagismus, and false contractions. 



(ESOPHAGITIS. 

Inflammation of the oesophagus may be due to many different causes, 
and may occur in one of three different degrees of severity. It may 
be either superficial, i.e., limited to the epithelial layer of the mucous 
membrane ; or deep, affecting the entire thickness of the mucous mem^ 
brane (epithelium, corium, and oesophageal glands) ; or, finally, it may 
attack both the mucous and muscular layers. German authors recog- 
nise various divisions, such as erythematous, catarrhal, follicular, and 
phlegmonous oesophagitis. In reality these are not always different forms, 
but simply successive stages in the evolution of a single morbid condition. 

D.C. L 



146 DISEASES OF THE (ESOPHAGUS. 

Here we shall only study the ordinary forms of cesophagitis, leaving 
on one side those which occur symptomatically during foot-and-mouth 
disease, cattle plague, gangrenous coryza, actinomycosis, etc. 

Causation. The causes of oesophagitis may be divided into three 
groups of different character: — {a) Eough fodder (clover containing wrest- 
harrow, thistles, thorns, furze, or splinters of wood, etc.) must be placed 
in the first rank, for its repeated action abrades and irritates the mucous 
membrane to such an extent as finally to produce inflammation. This 
inflammation usually remains superficial and of moderate intensity ; its 
occurrence can be anticipated during years of scarcity, when the animals 
feed on rough and irritating material like fern, broom, heather, furze, etc. 

(h) Hot drinks, whether in the nature of beverages or medicinal 
draughts, are a frequent cause of oesophagitis if administered by careless 
or inexperienced persons. The mucous membrane is scalded over a 
varying area and with different degrees of severity, or is destroyed 
by the chemical action of such drugs as ammonia, dilute acids, iodine 
solution, etc. 

(c) Eough or clumsy manipulation in withdrawing or displacing 
foreign bodies, or merely passing the probang, produces that variety of 
oesophagitis termed traumatic. In clumsy hands oesophageal sounds or 
catheters may abrade or even tear the mucous membrane and subjacent 
tissues. 

Symptoms. These vary to some extent, according to the intensity 
of the inflammatory phenomena. If the lesions are superficial and only 
implicate the epithelium, as in catarrhal oesophagitis, the sj^mptoms often 
pass unnoticed, and only produce difficulty in swallowing. When inflam- 
mation has involved the entire thickness of the mucous membrane the 
immediate consequence is loss of appetite due to pain during swallowing. 
After the bolus of food has been masticated, and has passed into the 
pharynx, the animal stretches out its head and neck and seems to be 
making efl"orts to force it down the oesophageal canal. The progress of 
the bolus is slow and clearly difficult. 

In oesophagitis due to scalding the blisters are soon broken by the 
passage of food, the corium is exposed, and the animal has equal difficulty 
in swallowing either solids or liquids. The reflex action provoked by the 
passage of the food over these lesions may be so violent that the ingesta 
never arrive at the stomach, but are violently rejected by a sudden and 
unexpected antiperistaltic contraction. Even saliva is returned. More- 
over, in these cases the history is generally clear, and the animal is 
feverish or greatly depressed. These objective symptoms are very 
significant, and when, in addition, an abnormal and exceptional degree 
of sensibihty is detected at some point by palpation, they unmistakably 
indicate the existence of oesophagitis. 



(ESOPHAGITIS. 147 

The irregularity in deglutition, and therefore also in rumination, 
sometimes excites moderate tympanites without any very apparent cause. 
Should the condition still appear doubtful the oesophageal sound may be 
passed, but with great care. It generally aggravates the pain and pro- 
duces intense antiperistaltic movements, which the practitioner should 
not attempt to overcome. 

Complications. If oesophagitis is moderate, recovery is the rule. 
The symptoms of pain gradually diminish. 

When, on the contrary, inflammation is very intense, as in certain 
cases of traumatic oesophagitis, the injured spot may become infected 
and suppuration follow. The existing fever then persists or becomes 
more marked ; the animal is extremely depressed ; respiration may be 
difficult and accelerated, and appetite is entirely lost. 

If the oesophageal abscess remains submucous the diagnosis is 
difficult, but it is often problematical, even when the abscess develops 
in the cervical region. The jugular furrow (usually on the left side) 
becomes the seat of a severe diffuse inflammatory swelling, the course of 
which clearly indicates the development of the symptoms. In exceptional 
cases fluctuation may be detected. 

If from the first the abscess develops around the oesophagus or in the 
course of suppuration comes to occupy this position, swelling in the 
jugular furrows is more apparent and easier to detect, and in this case 
fluctuation may be localised. When the lesions are within the thorax 
no tangible symptoms can be detected. Death may occur in a few days, 
when an abscess in the lower cervical region breaks into the anterior 
mediastinum, or when an abscess in the thoracic region opens into the 
pleural cavity. In oesophagitis produced by scalding and from swallowing 
hot or caustic liquids the mucous membrane, and sometimes the muscular 
tissue, is destroyed, and ulcerations and cicatrices result, or the oesophagus 
may even be perforated, with rapidly fatal results ; even when recovery 
occurs, cicatrices form and cause very grave contraction. 

Diagnosis. The diagnosis is generally easy, provided that the 
symptoms noted are methodically analysed and the history of the 
case is taken into consideration. 

Prognosis is favourable in ordinary cases. On the other hand, it 
may be very grave when general symptoms become marked, when the 
vital functions are disturbed and a deep-seated abscess appears to be 
forming. 

Lesions. In the first degree the lesions are confined to inflammation 
and desquamation of the epithelium ; in the second, to inflammation of 
the corium and of the mucous membrane ; in the third, to infiltration of 
the submucous layers and of the muscular and perioesophageal tissues. 
Sloughing and perforation follow the administration of caustic liquids. 

L 2 



148 DISEASES OF THE (ESOPHAGUS. 

Treatment. As the direct application of medicines to the inflamed 
mucous membrane can only be of a momentary character, treatment is 
confined to administering emollient, anodyne, and slightly astringent 
drinks, the action of which is assisted by feeding with milk, farinaceous or 
mucilaginous foods. Under these circumstances recovery occurs in ten 
to fifteen days. The application of stimulant or blistering ointments 
along the jugular furrow^ may have a good effect. 

When the general condition of the patient becomes aggravated, and 
the formation of an abscess appears certain, it is best to recommend 
slaughter. In the case of a submucous abscess the passage of the pro- 
bang may, how^ever, predispose or cause the abscess to open into the 
oesophagus, and thus lead rapidly to recovery, but this is exceptional. 
The "pointing" of the abscess and its opening towards the jugular 
furrow may be followed by temporary improvement, but at a later stage 
is followed by fistula formation, or by contraction of the oesophagus 
itself. From an economic standpoint it is better to slaughter. 

STRICTURE OF THE OESOPHAGUS, 

Under normal conditions the cavity or lumen of the oesophageal tube 
is, so to speak, imaginary : the w^alls of the tube lie flatly together, and 
the mucous membrane is in folds. During the act of swallowing the 
tube becomes dilated to a degree varying with the size of the bolus of 
food, and again retracts as soon as deglutition is effected. Whenever the 
dilatability of the tube is markedly diminished by changes in its walls, 
and, in a much higher degree, wdien this dilatability has disappeared, 
true stricture exists. In the former case small boluses of food and 
liquids alone succeed in passing the stricture ; in the latter, liquids alone 
can pass. 

Causation. Strictures are never primary. They result from intense 
attacks of oesophagitis, ending in sclerosis of the mucous coat, extensive 
ulceration consequent on scalding, or interstitial inflammation affecting 
the muscular coats, which then become thickened or sclerosed. 

Internal injuries due to attempts to withdraw or propel foreign 
bodies along the oesophagus may also cause strictures. 

Lesions. In simple strictures the lesions are confined to the develop- 
ment in the depths of the mucous membrane and in the muscular layers 
of inflammatory tissue, which becomes denser with lapse of time. This 
alters the character of the walls and the structure of the tissues, and 
causes them to lose their elasticity. After extensive ulceration the tissue 
of the cicatrix contracts and hardens to a very varying degree. 

Symptoms. The apparent symptoms are very clearly marked ; the 
appetite is good, and the animal masticates as usual, but in the act 
of deglutition is seen to extend the head on the neck, and to make 



STRICTURE OF THE (ESOPHAGUS. 



149 



1 \ 

\ 
K 



efforts to s^yallow, ^yhicll prove unavailing when the contraction is 
too marked. A reflex antiperistaltic movement often causes the sub- 
stances ingested to be at once rejected. These violent efforts, however, 
in time provoke dilatation above the stricture. A quantity of food 
accumulates in this dilatation, and the symptom so characteristic of 
oesophageal stricture then appears — viz., regular regurgitation. The 
second constant sym^Dtom associated w^ith compression or obstruction 
of the oesophagus is tympanites after feeding, however trifling may 
be the amount SW' allowed. Eumination is 
suspended, and even eructation of gas is 
difficult. Finally, the characteristic sign of 
stricture is noted on passing the probang, 
which reveals the existence of the condition, 
indicates its position, and suggests its degree 
of development. 

Diagnosis. Strictures only develop pro- 
gressively and slowly, a fact which enables 
them to be differentiated from oesophagitis. 
It is more difficult to differentiate them 
from dilatations, because the stricture always 
ends by becoming complicated with dilata- 
tion ; but this distinction is of little prac- 
tical importance, the consequences being 
identical. 

Prognosis. The prognosis is very grave, 
and there is no economic reason for attempt- 
ing treatment except in special cases ; the 
indications are in the direction of slaughter. 

From the economic standpoint there is 
no treatment. Basing their actions on 
human practice, the Germans have recom- 
mended progressive dilatation of the lumen of the oesophagus by passing 
a series of catheters of gradually increasing size. What, however, is 
justifiable in human medicine, where the only object is to keep the 
patient alive at any cost, may be highly objectionable in veterinary 
practice ; and in the present instance this is the case. Except in very 
rare instances, which the practitioner alone can appreciate, dilatation is 
contra-indicated, and the ow^ner's interest lies in slaughtering the animal 
before it has lost much condition. 



U 




Fig. 65. — Schema of recent 
and okl-standing contraction 
of the oesophagus. K, simple 
contraction; D, secondary 
dilatation. 



DILATATION OF THE OESOPHAGUS. 

Dilatations are more frequent than strictures. Their mode of origin 
is easily understood. When the muscular tissue has lost its tonicity and 



150 



DISEASES OF THE (ESOPHAGUS. 



contractile power at a given point, or when, as a consequence of any form 
of inflammation, it has begun to undergo atrophy, the mucous membrane 
becomes herniated, because its circumference is not supported regularly 
during deglutition. The ectasia, which at first is of small size, becomes 
more marked in consequence of the tendency that exists for the food to 
accumulate in the dilated region. Dilatation is thus set up. 

Localised attacks of oesophagitis, accidental injuries and fissuring of 
the oesophageal muscular tissue, produced by clumsy efforts to displace 
foreign bodies with the probang, are the principal 
causes of dilatation. When the probang is impru- 
dently or clumsily manipulated, it may press exces- 
sively at any point where the oesophagus makes a 
slight bend, and thus split the contracted muscular 
coat without injuring the lax mucous membrane. 

(Esophageal contractions, as we have seen, may 
form the point of origin of dilatations, but in this 
case the dilatations are more regular in form, and 
affect the entire circumference of the tube. The 
muscular tissue is still everywhere normal, and 
becomes dilated in consequence of equally-applied 
excentric pressure. 

Symptoms. When the dilatation develops 
slowly and progressively, as a consequence of mus- 
cular atrophy, the symptoms remain unnoticed for 
a long time, and the owner only begins to be 
anxious when the animal loses condition, or when 
the driver or cowman detects masses of half-chewed 
food mixed with the saliva in the manger. 

Certain signs are pathognomonic ; others may 
be regarded as of secondary importance. By care- 
fully watching an animal which is feeding the 
following symptoms may be noted : As a general 
rule hunger is very marked, and the animal chews 
its food and swallows the first few mouthfuls in a perfectly normal way. 
Three, five, eight, or even ten mouthfuls may be sw^allow^ed ; then the 
animal suddenly stops, appears a little anxious, extends its head and 
neck, an antiperistaltic contraction occurs, and one or two masses of 
food are rejected and fall into the manger. The discomfort being thus 
momentarily relieved, the animal, which is dying of hunger, although 
faced with food which it is unable to swallow, returns to its meal, swallows 
one, two, or three boluses of food, regurgitation again occurs, and the 
whole process is repeated. 

What is going on under these circumstances is easy to explain. 




Fig. 66.— Schema of 
oesophageal stricture 
(the muscular layer 
above the stricture 
has undergone atro- 
ph}^ ; the mucous 
m e m b r a n e is di- 
lated). 



DILATATION OF THE (ESOPHAGUS. 151 

At the commencement of the meal the dilatation is usually empty, or 
nearly empty. A mouthful of food is swallowed. It descends the oeso- 
phagus until it arrives at the diverticulum, into which it partially or 
wholly passes, the peristaltic wave of contraction ceasing at this point. 
The second mouthful follows with the same result, then a third, a fourth, 
etc. The diverticulum soon becomes filled to repletion, and no more food 
can enter it. The food therefore accumulates in the upper portion of the 
oesophageal tube until the latter becomes nearly filled ; but as this tube, 
provided its innervation is intact, is intolerant of the presence of any 
foreign bod}?-, and as efforts to swallow prove fruitless, a sudden anti- 
peristaltic wave of contraction occurs, with the result that all the material 
contained in the tube above the dilatation is ejected into the mouth, 
whence it falls into the manger. The same result follows any further 
attempts to swallow during a particular feeding time. From this it will 
be seen that the animal can ingest at a given time only as much as the 
dilatation will contain. 

In the intervals between meal times and under the action of the saliva 
and warmth, the food collected in the dilatation becomes softened, breaks 
down, and slowly moves onward towards the rumen. When the next 
feeding time arrives the dilatation is almost empty, and the same set of 
symptoms recurs. 

If, instead of forage, the animal begins by taking gruel or very fluid 
material, deglutition appears normal, or at least fairly easy ; but if drinking 
is deferred until after taking hard food, it becomes almost impossible, 
because the passage is obstructed. These symptoms are, so to speak, 
pathognomonic. Under any circumstances they are so significant that 
error in diagnosis is unlikely. 

By careful examination oesophageal regurgitation can very easily be 
distinguished from true vomiting ; the character of the rejected material 
shows that it has not come from the stomach, while the boluses of food 
preserve their cylindrical form, and are still saturated with saliva. 

Some secondary signs also deserve to be mentioned, such as the 
animal's anxiety and restlessness whilst its neighbours are feeding, the 
existence of trifling and intermittent tympanites due to suppressed 
eructation, suppression or irregularity of rumination, constipation, etc. 
At a later stage there is rapid wasting and disordered appetite, and 
finally the patients die slowly of hunger, whatever efforts are made to 
feed them. 

When the seat of dilatation is in the cervical portion of the oesophagus, 
there are other symptoms which leave no doubt as to the condition. 
When empty the pouch cannot be detected ; but during a meal the accu- 
mulation of food causes it to assume the appearance of a doughy, diffuse, 
indolent swelling, which alters the outline of the jugular furrow, yields 



152 DISEASES OF THE (E.SOPHAGUS. 

to pressure, and sometimes produces respiratory disturbance by pressing 
on the trachea, the pneumo-gastric and inferior laryngeal nerves, etc. 

When the dilatation is intra-thoracic and the above-described symptoms 
have been observed, the dilated spot can only be detected and localised by 
using the probang. The greatest possible prudence, ho^Yever, is required 
in manipulating the instrument, in order to avoid rupturing the thin walls 
of the dilated portion. 

The diagnosis is not always easy; when food is regurgitated, and 
one finds by auscultation that the sound usually produced by the passage 
of solids or liquids into the rumen is absent, there need be no hesitation 
in diagnosing either a dilatation or a stricture. The cHnical consequences 
being the same, the possible error would be of little importance. 

Prognosis. The animal's life is rarely in immediate danger, but from 
the economic point of view the prognosis is extremely grave, and it is in 
the owner's interest to slaughter the animal as soon as possible in order 
to avoid loss. Even in cases of dilatation in the cervical region, surgical 
interference is not advisable. 

Treatment. As foreshadowed by what has been said, there is no 
rational economic treatment. When the dilatation is in the cervical region, 
one might in exceptional cases attempt to restore the regular calibre of 
the oesophagus by removing an elliptical portion of mucous membrane, 
and bringing the muscular tissue together with sutures ; that is to say, 
when the rupture or fissuring of jfche muscular coat has been accidental. 
But as one is usually unable to remove the primary cause, to which the 
change in the muscular tissue is essentially due, the dilatation would 
recur without the operation having conferred any benefit. 

When an exact diagnosis has been made, the only useful indication 
is to confine the animal to very fluid food, which will not obstruct the 
oesophagus. Ordinary forage should be withheld. 

OESOPHAGEAL OBSTRUCTIONS. 

In this chapter we shall only consider such obstructions as occur in 
consequence of the animal having attempted to swallow without sufficiently 
chewing objects which become arrested in the oesophagus. 

Obstruction is termed "total" or " partial," according as the obstructing 
body fills the entire calibre of the oesophagus at the point of obstruction, 
or only occupies a part of the space. Partial obstructions produced by 
beet and turnip tops, etc., are usually but momentary ; liquids and saliva 
are still able to pass between the obstruction and the walls of the tube, 
and as soon as the arrested food becomes a little softened it is displaced 
and the oesophagus again becomes patent. 

Causation. The circumstances under which this accident occurs are 
extremely easy to understand. Obstructions are produced by apples, 



(Esophageal obstrijctions. 15^ 

potatoes, turnips, carrots, cabbage-stalks, beetroots, etc., which, whether 
shced or not, are swallowed gluttonously. Not having been sufficiently 
comminuted, and being of larger size than the oesophagus can readily 
accommodate, they become arrested at some point between the com- 
mencement of the cesophagus or a few inches behind the pharynx, or 
just in front of the point of entry of the gullet into the stomach. The 
latter is the commonest position, though not infrequently the obstruction 
occurs in the intra-thoracic portion. 

It may occur in the stable, but is commoner in animals which, having 
broken loose, have entered orchards, gardens or potato or turnip fields 
and attempted to swallow apples, cabbages, potatoes, etc., found there. 

In sheep, obstruction of the oesophagus is due to similar causes, but 
in their case the above-mentioned objects are replaced by small wild 
apples, turnip shells, Jerusalem artichokes, horse-chestnuts, carrots, etc. 

The symptoms may be divided into general and local. 

General symptoms. As soon as the foreign body becomes fixed in 
position, the animal begins to make exceptional efforts to swallow. The 
head is extended on the neck, and the oesophagus and the muscles sur- 
rounding the trachea are violently contracted. These efibrts proving 
fruitless, feeding is necessarily stopped, and the animal at once appears 
slightly anxious. 

Yery soon afterwards salivation sets in, saliva being continuously 
secreted. If the obstruction is total, the saliva cannot be swallowed, 
and is either returned in quantities by antiperistaltic movements or 
escapes in frothy filaments from the mouth. 

Tympanites is not long in appearing. It is progressive, and results 
both from arrest of eructation and from continued fermentation in the 
rumen. It may eventually come to a standstill, or may continue and 
threaten to produce asphyxia. 

Local symptoms. The local symptoms are difficult to appreciate, 
except in cases of cervical obstruction. Sometimes the foreign body 
produces a local swelling, which changes the outline of the jugular 
farrow, most frequently on the left side. In many cases it can only 
be detected by manipulating the parts between the trachea and the 
lower surface of the cervical vertebrce. When the obstruction is within 
the thorax, the probang alone can detect its position. 

Diagnosis. The diagnosis is usually easy. The history and the 
observed symptoms are often very clear, and the suddenness with which 
the obstruction has made its appearance prevent the condition from 
being confused with dilatation or stricture. 

The prognosis is very variable. It is often easy to remove the 
obstacle ; in other cases intervention is difficult, and death may occur 
rapidly. 



154 DISEASES OF THE (ESOPHAGUS. 

Treatment is confined to one essential point — removal of the 
obstruction. The chief difficulty lies in choosing the mode of inter- 
vention. Moreover, success dej^ends on several factors, which, in the 
order of their importance, are as follows : the size of the obstructing 
body ; the time which has elapsed since the accident occurred ; the 
bodily condition of the animal— i.^'., whether it be fat or thin — and the 
extent to which tympanites has developed. 

The first thing to do (and in favourable cases all that is required) is 
to puncture the rumen and leave the canula for some time in position. 
The onward progress of the foreign body, especially when the obstruc- 
tion is in the intra-thoracic portion of the tube, is often impeded by the 
tympanites, which tends to thrust the object towards the pharynx, or at 
least to fix it in position. In consequence of a sudden change in the 
conditions of pressure the foreign body may move and pass into the 
rumen ; all danger is then at an end. 

Even though the obstruction does not immediately cease, puncture of 
the rumen, by removing the danger of asphyxia, allows one at least to 
wait for several hours, sometimes until next day, during which time the 
object may pass into the rumen withoat further extraneous assistance. 
The other methods may be grouped into four series : 

I. External taxis. This is directed towards loosening the foreign 
body and thrusting it towards the 23harynx and buccal cavity. It can 
only be used against obstructions in the cervical region. Two methods, 
although very ancient, are still practised. 

(a) The first is carried out in the following way : the animal is fixed 
to a post or tree so that it cannot struggle, its head being drawn up as 
high as possible. The operator stands on the left side, with his back 
turned towards the patient's head, his left hand is pressed into the right 
jugular furrow, his right hand is placed on the left jugular furrow imme- 
diately below the foreign body. By using the fingers the foreign body 
is moved, and is progressively thrust towards the pharynx, in spite of the 
animal's efforts to swallow. In carrying out this manipulation it is 
absolutely indispensable not to let slip the obstructing body for a single 
instant, otherwise the peristaltic action will immediately return it to its 
former place. When it has been raised as far as the pharynx, an 
assistant passes his hand into the back of the mouth, as indicated in a 
former chapter, seizes the object and withdraws it ; or, instead, the 
assistant takes over the operator's duties, while the latter himself 
extracts the foreign body. 

(b) In the second method the animal is fixed in a different position, 
the head being held about 10 to 12 inches from the ground, with the 
neck lowered and inclined towards the earth. As in this position the 
oesophagus is longitudinally relaxed, and can be dilated to its fullest 



(ESOPHAGEAL OBSTRUCTIONS. 



155 



c 



extent transversely, the difScultj of displacing the obstacle should be 
very much less. In this case the operator always stands on the left side 
of the neck, but \Yith his back towards the animal's body. The right 
arm is passed around the neck and the right hand pressed into the 
right jugular furrow, the left hand being similarly engaged in the left 
jugular furrow. The method of employing the fingers 
is identical, or instead of the fingers the thumbs may 
be used. 

When the obstructing object has been lifted as far 
as the pharjaix it has a tendency to fall out of the 
mouth, and if it fail to do so it can be fixed in position 
and removed as in the preceding case. 

II. Extraction. These methods are applicable to 
cases where the foreign body has become fixed in the 
cervical region, but more especially to obstructions in 
the intra-thoracic part of the oesophagus. In the 
majority of cases they are dangerous, and may lead 
to j)inching, rupture, or perforation of the oesophageal 
mucous membrane. They should therefore be re- 
garded as exceptional measures. Theoretically, the 
instruments described are perfect, but practically they 
do not secure the results anticipated, because one can 
never prevent displacement, wrinkling, and involution 
of the oesophageal mucous membrane. 

The forceps probang has the drawback of seldom 
grasping smooth foreign bodies with sufficient firm- 
ness to permit of their extraction. 

The corkscrew sound exposes one to the great 
danger of completely piercing the oesophagus, because 
it has to be managed blindly, and because one never 
knows at what depth the corkscrew portion should be 
protruded in order to obtain a proper hold of a foreign 
body. 

III. Passage of the probang. When taxis fails or 

is inapplicable, we are forced to attempt thrusting the foreign body 
onwards. The method is much safer than the preceding, but, never- 
theless, demands great tact, prudence, and gentleness. Suitable oeso- 
phageal sounds are made with cupped extremities, though in cases of 
emergency an instrument can often be successfully improvised from a 
cane, whip handle, or flexible stick, about 4J to 5 feet in length, securely 
wrapped at one end with cloth or tow and freely coated with some greasy 
material such as lard, vaseline, or oil. 

The end of the sound having arrived in contact with the obstacle. 



Fig. 67.^ — (Eso- 
phageal sounds. 
Probands. 



156 DISEASES OF THE (ESOPHAGUS. 

the operator exercises moderate but permanent pressm-e. The obstacle 
may not move mimediately, because of spasm of the oesophagus, which 
grasps it. It is therefore necessary to wait and to take advantage of a 
moment when the resistance is less, and even then the obstacle may 
not move. 

Kough manipulation with improvised sounds may tear, fissure, or 
perforate the muscular and mucous coats, producing the gravest 
consequences. 

lY. Crushing. The crushing of an obstruction in the cervical 
region was long ago suggested, and is still greatly commended by 
empirics and farriers. It is performed by means of a little mallet and a 
piece of board. The method is barbarous, and exposes the animal to 
such grave complications as crushing of the oesophageal walls, follow^ed by 
necrosis, laceration of the connective tissue, and interstitial haemorrhage, 
injuries of the superficial or deep-seated jugulars, of the carotid artery, 
pneumo-gastric nerve, etc. It should never be practised, even although 
attempts have been made to improve it by replacing the mallet and board 
by specially formed forceps intended for crushing potatoes or roots. 
Only in the rare cases where one is certain that the foreign body consists 
of a very ripe fruit could crushing be justified, and in this case there is no 
need to have recourse to special instruments, for the hands alone suffice. 

Injection of alkaloids. The practitioner occasionally finds him- 
self in the embarrassing position of having vainly tried all the above 
methods. Before adopting the last resource, viz., oesophagotomy, it is 
then worth w^hile to test the action of certain alkaloids, injected sub- 
cutaneously, after having punctured the rumen. 

We know that pilocarpine and eserine stimulate secretion and the 
action of the bowels. Injected under the skin they cause frequent 
swallowing efforts, and intense peristalsis extending throughout the 
length of the digestive tract. Doses of 1^ to 2 grains of pilocarpine and 
1 to IJ grains of eserine, according to the size of the animal, sometimes 
produce excellent results, and rapidly remove obstructions. 

Apomorphine, the effects of which are, so to speak, inverse, because 
they tend to produce anti-peristalsis and vomiting, may be tried in doses 
of 2 or 3 grains. 

QEsophagotomy. The last resource is oesophagotomy, which, how- 
ever, is only applicable in cases of obstruction of the cervical portion of 
the oesophagus. It should be performed as described in the section here- 
after on operative manipulation. (See also Moller and Dollar's "Eegional 
Surgery," p. 166.) 

The point selected is necessarily governed by the position of the 
obstacle. There is no need to enter into full details. We may remark 
that it is not always necessary to perform the complete operation, and 



RUPTURES AND PERFORATIONS OF THE (ESOPHAGUS. 157 

the third and fourth stages can sometmies be avoided b}^ substituting for 
them attempts to break down the foreign body by submucous manipula- 
tion. The oesophagus, having been exposed and isolated, is punctured 
with a straight tenotome immediately below the obstacle. A curved 
tenotome is then introduced, and the root, potato, or fruit divided. As a 
rule, a little pressure from the outside then causes one or other of the 
fragments to move onwards and deglutition becomes normal. 

Attempts have also been made to divide the obstructing body directly 
without previous incision and without isolating the oesophagus. It is 
much more difficult, for the least movement of the patient changes the 
relationships of the super-posed layers and introduces obstacles to the 
manipulation of the blunt-pointed tenotome which is employed. More 
success often attends attempts to puncture the object with a fine trocar. 

RUPTURES AND PERFORATIONS OF THE CESOPHAGUS. 

Causation. Wounds of the oesophagus caused by external violence 
are rare, or at least secondary ; lacerations produced from within, on 
the contrary, as a result of clumsy manipulation are relatively frequent. 
They may extend throughout the length of the tube, but in a far greater 
number of cases are found near the entrance to the stomach at the point 
where the oesophagus turns towards the left. 

The passage of the oesophageal sound or probang is apt to exaggerate 
this curvature, and if pushed violently the instrument may produce first 
a flexure, then a partial rupture or even a perforation of the tube. 

In other cases a rough, irregular, infected foreign body may when 
swallowed penetrate the wall and cause inflammation, necrosis and 
perforation of the oesophagus. 

The symptoms are always very grave, and of rapid development. 
They consist in local oedematous swelling, sero-sanguineous infiltration 
at the entrance to the chest, in the pretracheal region and along the 
jugular furrows. 

The pneumo-gastric and inferior laryngeal nerves being compressed, 
dyspnoea results. If the oesophagus is perforated in the thoracic cavity 
septic pleurisy at once sets in. 

Diagnosis. The diagnosis is easy, provided the history point to 
perforation of the oesophagus. 

The prognosis is fatal Avhenever the perforation is within the thorax. 
It is sometimes possible to intervene in cases of perforation in the 
cervical region, but from the economic standpoint such intervention is 
of little value. 



CHAPTER IV. 
DEPRAVED APPETITE— PICA— THE LICKING HABIT. 

Depraved appetite, causing animals to swallow bodies which cannot 
properly be described as food, is frequent. The condition is commonest 
in adult animals of the bovine species, in calves and in lambs. The 
consequences are sometimes very serious, so that although depraved 
appetite does not represent a well-defined morbid entity, it is important 
to be in a position to remedy it. 

Depraved appetite does not appear under the same conditions in 
young and in old animals. In adults it often results from faulty 
feeding, or from some wasting disease which develops insidiously, or 
remains unrecognised ; in young animals it is the result of insufficient 
nourishment. 

Roloff & EoU hold that pica is the first symptom of osteomalacia 
(which see). 

DEPRAVED APPETITE IN THE OX. 

Causation. In the bovine species depraved appetite occurs in adult, 
debilitated animals, which are often, though not always, suffering from 
some well-marked digestive disturbance. 

The frequency of this symptom, and the peculiarities in its occur- 
rence, have caused it to be referred to a large number of different causes, 
among which may be mentioned bad hygiene, chronic gastro-enteritis, 
tuberculosis, osseous cachexia, pasteurellosis, gestation, etc. 

It is very certain that the peculiarity in the appetite is, above all, the 
result of incomplete and irrational alimentation. The animal has certain 
special requirements, to meet which the food must be of suitable compo- 
sition. If these alimentary and digestive conditions are not fulfilled, 
depraved appetite may occur, even in animals which appear well 
nourished. Certain authors refer the appearance of this condition to 
want of certain soda salts in the daily ration, and, in support of- this 
opinion, they point to the frequency of the disease in mountainous 
regions where the geological formation is chiefly granite, as in the Black 
Forest. Alluvial soils are supposed not to produce it. It. certainly seems 
more common on soils lacking in certain constituents or exhausted by 



DEPRAVED APPETITE IN THE OX. 159 

repeatedl}^ growing certain crops. Nevertheless, in France it might be 
urged that pica occurs equally on all kinds of soil, and a German author, 
Lemke, ascribes this perversion of nutrition to the want of phosphorus. 
Haubner and Siedamgrotsky attribute it to a nervous disorder. All causes 
which exhaust the organism, especially all chronic diseases of digestive 
origin, may induce aberration of appetite. 

Permanent stabling, confinement, absence of sunlight, want of exer- 
cise and pure air contribute to the general debility which predisposes to 
attack. Dry seasons, by reducing the supply of food, have a similar effect. 

In tuberculosis and in pasteurellosis, it is the general organic de- 
cline which produces these puzzling changes in appetite. Similarly 
the influence of gestation depends on the superadded demands on 
the organism caused by the development of the foetus. 

Symptoms. The symptoms may be divided into two phases. 

In the first phase, the animals still preserve their appetite, but 
whenever they have an opportunity they eat earth, sand, manure, litter 
saturated with urine, plaster, etc. They lick the walls, the boarding, the 
mangers and the trees, and they chew and swallow linen spread out to 
dry. 

This phase may continue for a very long time, three to four months 
or more, provided no acute complication results from the eating of such 
foreign material. There is no fever, but the appetite, although well 
preserved, is often capricious, and the ordinary food is eaten slowly. 

In the second phase, which frequently marks the development of 
complications produced by the passage, contact, or prolonged sojourn of 
various materials in the digestive tract, fever appears, little marked as a 
rule, but continuous in character. 

The appetite is diminished. The animal wastes ; the secretion of 
milk diminishes, and signs of chronic gastro-enteritis may be noted. The 
perversion of appetite still continues ; rags, decomposing or filthy 
materials, pieces of old shoes, etc., are eaten, and it is not surprising 
that such substances should have an unfavourable eftect on the mucous 
membrane of the digestive tract. 

The wasting process slowly leads to marked emaciation, and after an 
interval of from six months to a year, or even two years, the patients 
die in a state of complete exhaustion. The lesions found on post-mortem 
examination are those of various diseases capable of producing depraved 
appetite or simply lesions of chronic gastro-enteritis. 

Diagnosis. The diagnosis presents no difficulty. The important 
point is to discover whether or not there exists some previously un- 
recognised primary disease. 

Prognosis. The prognosis of this condition is grave, because de- 
praved appetite is frequently only a symptom of some incurable disorder. 



160 DEPRAVED APPETITE — PICA — THE LICKING HABIT. 

or because the changes m the digestive mucous membrane are ah-eady 
too far advanced to permit of much improvement. 

The lesions comprise : general emaciation, presence of a yellow 
serum in the fatty tissue, muscles pale and flabby, catarrh of the 
mucous membrane of the stomach and bowel. The blood seems less in 
quantity and coagulates feebly or not at all. 

Treatment. The treatment should be directed against the primary 
cause, if such exists (osseous cachexia, pasteurellosis, gestation, etc.). 

In other cases a change in management and in feeding, and the 
administration of food rich in mineral salts like chlorides, carbonates, and 
phosphates of lime, soda or potash, produces the best possible results. 
The leguminous foods, sainfoin, clover and lucern, are to be recommended. 
The animal, if formerly stabled, should be turned out and its living con- 
ditions entirely altered. 

It is often useful to place a block of rock salt in the manger ; when 
hyperacidity of the stomach is suspected lime water, chalk, or magnesia 
should be given. Where digestion is weak or slow HCl, pepsin and 
vegetable bitters are indicated. Nevertheless, one sees cases which refuse 
to yield to any of the ordinary methods. In treating these, Lemke has 
recommended the subcutaneous injection of chloride of apomorphine, a 
drug which may be regarded as a true specific. The doses vary between 
1^ and 3 grains, and an injection is given once a week for three weeks in 
succession. After this the tendency to pica is said to disappear aiid the 
general condition to improve. The treatment must be repeated every 
three months in countries where depraved appetite appears general and 
permanent. 

It is difficult to understand by what mechanism this drug produces 
the effects attributed to it, but those who have employed it speak very 
highly of its action. 

We may add that in addition to the different modes of treatment, it is 
not infrequently necessary to hastily perform gastrotomy in order to 
avoid fatal consequences, which would otherwise follow indulgence in 
this habit. When an animal has swallowed a considerable quantity of 
linen, for example (and Moussu has seen cases in which many pounds 
weio-ht had been devoured), immediate intervention is required to avoid 
intestinal obstruction. Furthermore, when the history is quite clear 
gastrotomy allows the entire mass of foreign bodies, ingested at different 
times, to be removed. 

DEPRAVED APPETITE IN CALVES AND LAMBS. 

Causation. Depraved appetite is commonest in calves and lambs 
when the animals are insufficiently nourished, or when the mothers are 
suffering from chronic debilitating diseases and are therefore yielding 



DEPRAVED APPETITE IN CALVES AND LAMBS. 161 

milk poor in fat and in mineral constituents. In a few rare cases it is 
impossible to discover what causes the young animals to devour these 
foreign materials. Even fully-grown sheep, when shut up together in 
winter, acquire the habit of chewing each other's wool, sometimes to 
the extent of virtually depilating their fellows and accumulating wool 
balls in their stomachs. 

Symptoms. Calves have a tendency to lick themselves or their 
neighbours, and thus little by little collect a varying quantity of hair 
which they swallow. When this habit of licking is little marked the 
quantity of hair ingested may not be dangerous ; but in the contrary 
case the hair (which cannot be digested) accumulates and is permanently 
retained in the abomasum. It soon becomes converted into masses, 
cemented together with mucus, and forms round balls, to which the name 
of oegagrophiles has been given. If these oegagrophiles, or hair balls, are 
of small size, they prove of trifling importance ; but too frequently they 
attain considerable dimensions and obstruct the pylorus or the intestine. 
The young calves then refuse all nourishment, and die in twenty-four to 
forty-eight hours in a state of complete exhaustion or after a series of 
epileptiform attacks. 

In lambs the complications due to depraved appetite develop in a 
similar way, but the wool swallowed is obtained from the mothers. The 
lambs first suck the locks of wool, then tear them off and swallow them. 
So long as these peculiarities of appetite are little marked no bad results 
follow ; but if the shepherd is careless, and fails to note the condition of 
his young flock sufficiently early, accidents occur. 

The wool is not so easily converted into balls as is hair, but it soon 
accumulates in the pyloric region or in the intestine, and forms obstruct- 
ing masses. The little patients lose appetite and lie down in corners, 
where they are found dead after twenty-four to forty- eight hours. The 
masses of wool or of hair are rarely passed with the excrement ; more 
frequently they are vomited, but this again is exceptional ; usually they 
become arrested at the entrance to the pylorus. The lambs show colic, 
tympanites of the abomasum, and attempts at vomiting, though unfor- 
tunately these are often overlooked. The quantity of wool found in the 
abomasum and intestine on post-mortem examination may be consider- 
able, in relation to the size of the digestive compartments. Death results 
from intestinal obstruction, exactly as in the case of calves. 

These aberrations of appetite in lambs have been considered as due 
to the want of sufficient mineral salts in the mother's milk ; and it has 
been stated that the lambs practise this habit because of the laxative 
result of the fat contained in the wool swallowed. The explanation seems 
very logical, though it is by no means perfectly proved. It is certain that 
this habit becomes particularly common after years in which forage has 

D.C. M 



162 COLIC. 

been scarce and among flocks in bad bodily condition. The force of 
examjjle also plays a certain part, and animals probably imitate one 
another, and so acquire the disease. This explains the importance of 
early segregation. 

Diagnosis. The diagnosis of depraved appetite, pica, or the licking 
habit presents no difficulty ; but it can only be arrived at by the cow- 
man or shepherd, for the symptoms can only be detected by continued 
watching. 

The diagnosis of pyloric or intestinal obstruction is very difficult in 
the absence of information. It becomes easy after the first post-mortem 
examination has been made. 

Prognosis. The prognosis is grave. In calves, obstruction of the 
bowel by hair-balls inevitably causes death, and in sucking lambs the 
mortality may be high : as much as 15 per cent, to 20 per cent, according 
to the observations of several observers. The mortality occurs about 
the age of six weeks to two months, whilst the licking habit may begin 
towards the end of the second week. 

Treatment. Prophylaxis demands that the mothers (whether cows 
or ewes) be well fed. An excellent precaution consists in adding to the 
food a sufficient quantity of salt and of phosphate of lime (2 drams 
to 2 J drams of each). This treatment of the mothers is necessary 
as soon as the tendency to licking becomes manifest. 

In calves the best method of avoiding fatal results is to prevent the 
young animals licking one another ; and the method now usually prac- 
tised on well-managed farms consists in applying a simple muzzle of 
wicker work immediately after each meal. 

In lambs treatment is more difficult. As soon as the shepherd 
sees any tendency to depraved appetite the lambs should only be left 
with their mothers w^hilst being suckled. The flock should be exercised 
in the open, and ordinary salt should be placed at a number of points on 
the ground occupied by the animals. 

COLIC IN THE OX. 

COLIC DUE TO INGESTION OF COLD WATEE. CONGESTIVE COLIC. 

Causation. Congestive colic occurs in the stable, in animals which 
have been doing heavy work, and, returning in a heated condition, drink 
large quantities of cold water. It is commoner when animals have not 
eaten for a considerable time, and when, therefore, the stomach is nearly 
empty. Under these circumstances chill of the digestive viscera is direct 
and immediate. 

Symptoms. This form of colic occurs suddenly, soon after the water 
has been swallowed, and is characterised by violent pain. At first the 



COLIC DUE TO INGESTION OF COLD WATER — CONGESTIVE COLIC. 163 

animals show uneasiness, stamp, and continually move about striking 
themselves in the flank with the feet or horns, swishing the tail, etc. 
They refuse food, lie down and rise frequently, and paw the ground. 

As a general rule this form of colic lasts from half an hour to one 
hour, and terminates in recovery. In some rare cases where death 
occurred Cruzel found on post-mortem examination congestion of the 
abomasum, and, in a few, congestion of the small intestine, with or 
without rupture. 

The diagnosis is easy, on account of the suddenness of onset, rapid 
development and history of the disease, discovered on questioning the 
owner or herdsman. 

The prognosis is not grave. This form of colic generally cures itself. 
Nevertheless precautions are required against possible complications, 
such as intestinal haemorrhage and invagination. 

The necessary preventive measures are self-evident. Animals return- 
ing from work should not be allowed to drink freely of cold water, but 
should first receive a little food and afterwards Avater at the temperature 
of the atmosphere. 

When colic has set in, the patient can be walked about. If pain 
persists, the region of the abdomen may be dressed with oil of turpen- 
tine, mustard, or similar counter-irritants. The application of warm 
clothing is also useful. Finally, in grave cases, a moderate quantity 
(three, four, or five quarts) of blood maybe withdrawn from the jugular. 
The administration of stimulants like wine, alcohol, etc., is also 
indicated. 

COLIC DUE TO INVAGINATION. 

Invagination consists in the passage of one portion of the intestine 
into the next-following portion. When once the condition has been set 
up it tends to become aggravated, the invaginated part being drawn 
further and further forwards. Invaginations therefore may vary in 
length between a few inches and sixteen to twenty inches. 

Law states (Yol. II. p. 317) that in cattle and swine invagination of 
the large colon is almost impossible owing to the relation of the bowel 
with the layers of the mesentery. The anatomical arrangement is 
opposed to the formation of invagination, yet this accident is not 
uncommon in cattle and swine. The small intestine can be invaginated 
into the caecum or into itself. The caecum may become invaginated, or 
it may pass into the colon or rectum. 

Cartwright, Veterinarian (1829), reports a case of invagination in 
a bull calf, and Youatt gives particulars of a similar case which was 
followed by sloughing and discharge per anum of the intussuscepted 
portion of bowel. (See also Moller and Dollar's " Eegional Surgery," 
p. 328.) 

M 2 



164 



COLIC. 



Causation. This variety of colic is due to a number of somewhat 
obscure causes. In a general sense we may say that anything which 
increases intestinal peristalsis increases the risk of invagination. The 
accident may follow intestinal congestion, but is most frequent in 
animals suffering from intestinal worms, or in animals used for heavy 
work. Under the influence of violent, tractive efforts the peristaltic 
movements are stimulated, and the intestine being in an oblique 




Fig. 68. — Invagination of the intestine in an ox (the constricting portion has 
been incised longitudinall}^). 

position on a plane inclined backwards, the contracted portion may slip 
into the dilated section behind it. 

Invagination may also occur without any apparent cause, even in 
animals standing in the stable. 

Symptoms. The attack always occurs suddenly, develops rapidly, 
and is of an extremely grave character. 

Colic comes on while the animal is working, moving about, or resting, 
according to circumstances, and at first resembles that due to congestion. 
It afterwards becomes very violent ; the animals paw, stamp, show great 
uneasiness, throw themselves violently down, and rise suddenly, only to 
again lie down as before. The face expresses anxiety, suffering and 
depression ; the tail is often kept lifted, and efforts are continually made 
to defaecate, mucus being passed. By passing the hand into the rectum 
the invagination may occasionally be discovered. 



COLIC DUE TO INVAGINATION. 165 

Colic persists with great intensity for ten to twelve hours, interrupted 
only by rare periods of calm. At the end of this time, however, it may 
suddenly disappear, and the animal may fall into a semi-comatose state. 
This indicates the onset of necrosis in the invaginated section, the painful 
reflexes no longer being transmitted to the sympathetic system. The 
disappearance of colic is sometimes regarded as a sign of improvement, 
but this improvement is illusory. From this time onwards the animals 
stand stolidly, obstinately refusing both food and drink. If they lie down, 
it is with great care. Palpation of the right side of the abdomen is 
painful, and the animal actively resents it. One of the most important 
and constant signs at this stage is the absence of defsecation, due to ob- 
struction of the intestine, which is occluded. The animals may survive 
for ten, twelve, or even fifteen days (see also Moller and Dollar's 
"Eegional Surgery," loc. cit.). The invaginated, necrosed portion may 
even be passed with the fseces, and recovery may occur, the continuity of 
the intestinal tube being secured by the adhesion of the serous surfaces ; 
but such spontaneous recoveries are exceptional. Usually after a few 
days death results from peritonitis. 

Occasionally, trifling invaginations may become reduced spontaneously. 
Diarrhoea, with the passage of blood-stained material is then seen for a 
time, a sign which alone at this stage would justify the diagnosis of 
invagination. 

Diagnosis. The intensity of the colic and the absence of defaeca- 
tion for several days afterwards, justifies the diagnosis of invagination. 
Purgatives then remain without effect. In addition, rectal exploration 
offers a valuable means of diagnosis. The last portions of the intestine 
are found absolutely empty, and the arm when withdrawn is found to 
be covered with viscous blood-stained mucus, resulting from the sero- 
sanguinolent exudate, due to compression of the . blood-vessels. 

In cases of this kind accompanied by the above-mentioned symptoms 
abdominal exploration by the rectum should always be practised, but it 
rarely gives exact information. The hand, when passed towards the 
right flank, may sometimes reach the invaginated part, which conveys the 
impression of a cylindrical swelling. The invagination, however, can 
rarely be reached. If the operator is successful, he will find that as he 
displaces this cylindrical mass or attempts to grasp it, the animal shows 
signs of exaggerated sensitiveness. 

The prognosis is of exceptional gravity. Apart from the rare cases 
where the invaginated portion becomes necrotic and is eliminated, death 
is inevitable. Unless an operation is performed, septic peritonitis may 
develop about the fifth or sixth day. 

Treatment. The only treatment consists in surgical intervention. 
Some practitioners have recommended giving large doses of purgatives 



166 COLIC. 

with the idea of causing changes in the neighbourhood' of the invaginated 
part ; but such treatment presents httle chance of success. The same is 
true of the administration of large doses of ohve oil, either in the form of 
draught or of enema. 

Siebert attempted reduction by generating CO2 from soda bicarbo- 
nate dissolved in water and diluted HCl, injected successively per 
rectum. In time faeces and CO2 escaped, and the patient recovered. 
Siebert claims to have cured by this method a cow with invagination of 
five days' duration ; but the effect of his treatment may be doubted, as 
afterwards a portion of bowel was found in the cow's dung. 

When diagnosis is certain, the only treatment that can be recom- 
mended consists in performing laparotomy followed by enterotomy. 
One cannot, however, operate in all cases, nor do all cases offer the same 
chances of success. If the invagination is situated in the first portion 
of the small intestine, and is hidden beneath the circle of the hypo- 
chondrium, intervention is out of the question, but if it has been 
detected by rectal exploration in the last portion of the intestine, 
operation may prove successful. Only in cases of the latter description 
should it be attempted. 

Laparotomy is performed in the right flank according to the usual 
method (see Moller and Dollar's " Regional Surgery," p. 313). After 
opening the peritoneal cavity, the invaginated loop of intestine must be 
sought. It is not always easy to discover amongst the mass of intestines 
present, but can be recognised by its hardness and by the congestion 
of neighbouring parts. After withdrawing it through the abdominal 
opening, the operator may then proceed by one of several methods. 

(1.) Some authors recommend grasping the two ends, drawing them 
apart, and thus reducing the invagination. The actual manoeuvre is 
not difficult, but even when unattended by accident or tearing of the in- 
testine it is by no means always followed by recovery. Although the 
intestine may not appear gangrenous externally, necrosis often occurs 
eventually. 

This method should only be practised during the first twenty-four 
hours after the appearance of colic, and even then one must always bear 
in mind the possible consequences just mentioned, and the chances of 
rapidly fatal septic peritonitis. 

(2.) The second method consists in removing the invaginated portion 
of intestine. It is best to apply bichromatised catgut or silk ligatures 
to all the arteries which pass from the mesentery into the loop to be re- 
moved ; after which the loop itself may be simply divided an inch or two 
above and below the invagination, in order to be quite certain that one is 
operating on healthy tissue, the divided ends being held meanwhile by 
an assistant. The intestine is afterwards sutured with a fine needle and 



COLIC AS A RESULT OF STRANGULATION. 167 

bichromatised catgut or boiled silk. The form of suture will be found 
described in Dollar's " Operative Technique." It may be valuable to test 
the efficacy of decalcified bone tubes for uniting the ends of the intestine. 

The operation is long, delicate and difficult, and it is imperative not 
to infect the abdominal cavity during its performance. To prevent this 
the liquid and solid materials present in the bowel may be thrust upwards 
and downwards away from the diseased part before the section is made ; 
and in this way the wound and the operator's hands are preserved from 
infection. The intestine should be kept closed during the application of 
sutures by means of flat clamps cautiously applied. In their absence the 
ends may be held by an assistant, whose hands should previously have 
been carefully disinfected. 

(3.) In cases where the serous coats of the two portions of bowel con- 
stituting the invagination are to some extent adherent, another opera- 
tion of a less perilous character may be performed. This consists in 
liberating the invaginated part by means of longitudinal incision, without 
previously disengaging the parts, and without resection. The invagi- 
nated (external) portion of intestine is divided longitudinally ; the gan- 
grenous part immediately becomes visible, and may be removed. The 
operator has then only to suture the longitudinal wound, an operation 
w^hich is much easier and demands much less time than any circular 
intestinal suture whatever. These operations must not be attempted 
except in response to the express wish of the owner, who should be fully 
informed of the dangers to which they expose the animal ; for after 
the second day of invagination local peritonitis has often developed 
and one is then operating on injured or infected tissues, in itself a 
very unfavourable modifying condition. The current formula that " the 
operation was very successful " is not accepted in veterinary practice 
when the patient dies three or four days afterwards. From the eco- 
nomic standpoint it is better to slaughter animals of any value, for 
unless secondary peritonitis has occurred, and the animal is not feverish, 
the meat is fit for consumption. " Volvulus," or twist of the intestine, 
is said to be almost unknown in cattle, though Reichert records a case of 
volvulus of the ileum. 

COLIC AS A RESULT OF STRANGULATION. 

The symptoms of this colic differ very little from those of the preceding 
with which they are often confused. But in regard to its causation the 
condition is essentially different. 

Causation. Strangulation of the intestine in the ox may be produced 
in several different ways : by the passage of a loop of intestine through 
a tear in the epiploon, through the diaphragm, mesentery, broad liga- 
ment of the uterus, the serous layer surrounding the spermatic cord, etc., 



168 



COLIC. 



or by strangulation of an intestinal loop by fibrous bands resulting 
from chronic peritonitis, etc. Of these various causes, the three prin- 
cipal may here be described : — 

(1.) Tearing of the mesentery. As a result of mechanical violence 
the epiploon or mesentery becomes fissured, and the peristaltic move- 
ments cause a loop of intestine to pass through and become fixed in 
the fissure. If the opening is narrow, as is usually the case, the base 
of the intestinal loop, riding on the lower lip of the slit, becomes con- 
stricted by the margins of the opening through which it has passed. 

(2.) In pelvic hernia a loop of intestine passes between the spermatic 
cord and the walls of the pelvis. The fissure in this case is in the 
serous fold which supports the large testicular arteries and the vas 
deferens. The fold is often ruptured during castration, especially during 

the practice of " bistournage," in conse- 
quence of traction exercised on the cord. 

(3.) Pseudo - ligaments and fibrous 
bands due to chronic peritonitis. — -In 
local, subacute or chronic peritonitis false 
membranes may become organised, form- 
ing fibrous cords or folds connecting the 
parieto-visceral or inter-visceral surfaces. 
If by accident a loop of intestine insinu- 
ates itself beneath one of these fibrous 
bands, the passage of digestive material 
is first impeded and then stopped. The 
intestine becomes engorged, and symp- 
toms of strangulation soon follow. 
The symptoms appear suddenly, and are similar to those of inva- 
gination. They consist of very acute colic, which disappears after ten 
to twelve hours. 

The peristaltic movements drive the semi-digested food, whether liquid 
or gaseous, towards the lower (strangulated) end, from which it cannot 
escape. It therefore distends the herniated loop and sets up intestinal 
engorgement. This constitutes the first stage of strangulation, and is 
accompanied by severe disturbance in the local circulation. The mucous 
membrane of the intestine becomes swollen and infiltrated, so that it 
alone soon fills the entire neck of the hernia. Necrosis of the loop of 
intestine is then only a matter of time. 

The diagnosis of colic by strangulation is difficult. The condition 
cannot often be recognised at an early stage, and may easily and 
excusably be confused with invagination. Only in rare cases will rectal 
and abdominal examination enable one to detect a pelvic or mesenteric 
hernia. 




Fig. 69. — Schema of hernial 
strangulation. 



DISEASES OF THE STOMACH. 169 

The prognosis is even graver than in cases of invagination. Intes- 
tinal hernia progresses very rapidly, necrosis soon sets in, and is 
followed by fatal consequences if the condition be not relieved. 

The treatment is exclusively surgical. As a general rule, whenever 
colic is recognised as resulting from strangulated hernia, it is imme- 
diately necessary to perform laparotomy in the right flank, and after 
having discovered the cause of strangulation, to divide the mesentery, 
e]3iploon, serous fold supporting the testicular cord, or accidental fibrous 
bands, so as to free the herniated loop and avoid necrosis. If necrosis 
already exist, the intestine may be resected, exactly as in invagination. 

DISEASES OF THE STOMACH. 

In ruminants diseases of the gastric compartments are numerous, 
and, although they have been recognised since the earUest times, much 
remains to be discovered concerning at least some of them. This fact 
results from the imperfect state of our knowledge concerning the essential 
phenomena of gastric digestion in ruminants. Digestion really consists 
of a number of different acts — some mechanical or neuro-motor, some 
chemical ; in addition to which must be reckoned the phenomena of 
sensation, concerning which patients cannot give any information. 

The mechanical phenomena, consisting in the constant movement 
of ingested material through the different compartments, rumination, 
eructation, evacuation towards the intestine, etc., are well known to us; 
and a careful examination of diseased animals enables us to estimate the 
importance of changes in them. 

On the other hand, the chemical phenomena are little understood. 
It has hitherto been considered that the rumen, reticulum, and omasum 
are only simple diverticula, with mechanical functions, and that the 
abomasum is the reservoir in which the chemical changes take place. 
Another view, which is perhaps not altogether justified, presupposes 
that the chemical transformation of the food in the abomasum takes 
place as in other animals, and in particular as in man, in whom the 
chemistry of gastric digestion has been the object of extremely careful 
research by certain French and other pathologists. We do not believe 
(for reasons too long to be explained here) that the gastric digestion of 
ruminants, or even of herbivora in general, can be identified with that 
of omnivora. 

The nature of the food being totally difterent, the chemical reactions 
in the stomach and intestines are also different ; in proof of which we 
need only cite the single fact that ptyalin is absent from the saliva. 
Straw and oats are not digested in the same way as a mutton cutlet. 

But even supposing that the broad outlines of physiological action 



170 INDIGESTION. 

are the same, nothing has hitherto been discovered in veterinary surgery 
respecting possible variations in the chemical processes taking place in 
the stomach during different gastric diseases ; and it appears not impro- 
bable that in this direction causes might be discovered which veterinary 
practitioners have hitherto sought elsewhere. Excess or insufficiency of 
hydrochloric acid, and variations in the quantity of the organic acids, play 
so important a part in the theory of gastric pathology in man, that it is 
scarcely surprising to find similar ideas recurring in the pathology of 
domestic animals. The correctness of these views remains to be proved ; 
and without wishing actually to classify dys23eptic conditions as in man, 
we may assert that diseases described under other names stand in direct 
relation to variations in the gastric secretion or to disturbance of gastric 
movements — e.g., simple chronic tympanites, which, without a doubt, is 
often a neuro-motor dyspepsia. 

The classification we shall adopt in studying the diseases of the 
gastric compartments is, therefore, extremely simple. In the first 
series we shall consider sudden, accidental, and temporary forms of 
indigestion, and in the second series, acute or chronic forms of gastric 
inflammation. 

INDIGESTION. 

GASEOUS INDIGESTION. 

Gaseous indigestion, also described as indigestion of the rumen, is 
characterised by the rapid accumulation of gases (chiefly carbon dioxide, 
carbon monoxide, and marsh gas), due to fermentation in the upper 
part of the rumen. It is common in oxen and sheep, and has received 
the names of mephitic indigestion, acute tympanites, meteorism, etc. 
It occurs during or immediately after feeding. 

Causation. Numerous causes have been invoked to explain the 
sudden occurrence of gaseous indigestion. 

The most important is the particular condition of the animal at the 
moment when it has been attacked. For if external influences alone 
were responsible, there is no reason why all the animals of a given herd 
or flock, or of a particular stable, which are under similar conditions 
as regards feeding, etc., should not be affected in the same way. 

That the external causes cited (cold, excessive heat, stormy weather, 
etc.) may affect different animals differently and unfavourably is beyond 
doubt. But the temporary morbid condition of the animal itself is the 
essential condition to the development of indigestion. 

In all 251'obability the animal has in every case been more or less 
unwell, except in those attacks of indigestion resulting from progressive 
poisoning during the course of a meal, such as occur when toxic plants 



GASEOUS INDIGESTION. 171 

like belladonna, veratrine, colchicnm, poppies, tobacco, hemlock, etc., 
have been eaten. In such temporary abnormal states movement of the 
rumen is partly abolished, or at least is markedly retarded, and, as a 
consequence of vaso-motor disturbance, the mucous membrane is pro- 
bably not so abundantly covered with mucus nor so freely irrigated with 
secretion, as usual. Under these conditions, if the animal, which may 
appear perfectly well, is allowed to partake of soft, wet, fermentescible 
food, gaseous indigestion is very likely to develop. 

Cultivated grasses, like lucern, sainfoin, clover, and especially grasses 
grown on artificially manured fields, are regarded as particularly liable 
to cause gaseous indigestion. This conclusion seems justified by expe- 
rience, particularly^ by the fact that young shoots or young, tender 
after-growths are very liable to fermentation. 

This exaggerated tendency to fermentation of tender grasses has even 
been held exclusively responsible for indigestion, and the cessation of 
peristalsis in the rumen has been considered a secondary phenomenon, 
due to distension. 

"Whether atony of the rumen be the primary condition and abnormal 
fermentation secondary or inversely, whether fermentation be primary 
and atony secondary, is not of importance ; for either view may be 
adopted without altering the results, and without the theory being 
invalidated by the objection that other animals subjected to similar 
influences had not contracted the condition 

We have already drawn attention to the importance of the condition 
of the animal's health for the time being. Digestive peristalsis being 
diminished, eructation, admixture of food in the rumen, and its onward 
movement being impeded, fermentation proceeds raj)idly. As a conse- 
quence the rumen becomes distended, and, cause and effect changing 
places, the distension in its turn arrests peristalsis, which had previously 
only been checked. 

Local chills, produced by ingestion of food covered with rime, hoar- 
frost, or simply with dew, may favour gaseous indigestion ; such condi- 
tions retard or suspend the peristaltic movements by direct local action, 
and probably by producing vaso-motor disturbance of the mucous mem- 
brane. In very rare cases chill has an undeniable influence, either by 
provoking general vaso-motor disturbance, which reacts on the secretions, 
or neuro-motor trouble. Gaseous indigestion is not uncommon in animals 
living on dry winter food, which have been moved from their ordinary 
quarters and sent on railway journeys or to fairs, etc. As a general 
rule this form of indigestion is commonest in spring, when the transi- 
tion from dry winter food to grass, etc., has not been carefully 
effected. It is also frequent during stormy weather in full summer. 
Marked barometric changes seem to have an influence on the general 



172 INDICESTION. 

health, and particularly on the nervous system, thus favourmg organic 
fermentations. 

Symptoms. The earlier symptoms of indigestion escape observation, 
but they soon begin to develop rapidly, and are then very easy to follow. 
They always exhibit the same characters, developing, however, with 
more or less rapidity in different cases. Soon after they commence 
feeding animals appear to experience special discomfort, which causes 
those at grass to stop grazing ; even when stabled they stop feeding. 
From this time they show eructation, repeated yawning, restlessness, 
and some anxiety. 

In a quarter of an hour, or less, the left flank begins to project, both 
laterally and vertically, so that eventually the walls of that part of the 
abdomen may project above the transverse processes of the lumbar 
vertebrae. The right flank also becomes swollen, as a consequence of 
the intestine being thrust out of position. The animal very rapidly 
shows general disturbance ; the nostrils are dilated, the mucous mem- 
branes congested, respiration becomes rapid, and asphyxia threatens. 
The respiration soon becomes panting, for the distended rumen para- 
lyses the diaphragm and compresses the lungs. To ease respiration 
the animals open the mouth, extend the neck, and stand with the 
front limbs spread apart ; but this fails to prevent dyspnoea becoming 
more intense and asphyxia imminent. 

The heart beats more rapidly, the superficial veins appear swollen, 
and the mucous membranes cyanotic. The rhythmic contractions of the 
rumen can no longer be detected by manual examination of the left 
flank ; and on auscultation one neither hears the liquid nor the rolling 
sound, but only exaggerated crepitation. Finally, there is marked 
tympanitic resonance on percussion. 

In cases of very grave tympanites the gaseous pressure in the 
interior of the rumen appears to stop the crepitation sound. The 
animals soon beconiQ unable to walk or even to move, suddenly fall 
to the ground, and die rapidly from asphyxia. 

The rapidity with which gaseous indigestion develops varies greatly. 
Sheep and oxen may die from tympanites, within an hour or even half 
an hour of their arrival in the field ; but more frequently the symptoms 
develop slowly, only becoming alarming after some hours and continuing 
for twelve or even twenty-four hours without causing death. 

As a rule, the gas is voided by a series of eructations which empty the 
rumen, and recovery follows ; but when distension is extreme eructation 
cannot occur, and gaseous indigestion then ends in asphyxia and death. 

Lesions. It might be imagined that this form of indigestion would 
only appear when the rumen contains a large quantity of food ; but, 
in point of fact, the rumen often" contains very little. 



GASEOUS INDIGESTION. 173 

On post-mortem examination the rumen is found to contain an 
enormous quantity of gas, which, when collected and submitted to 
analysis, reveals approximately the following composition : — Carbonic 
acid, 74 per cent. ; carburetted hydrogen, 24 per cent. ; sulphuretted 
hydrogen, 2 per cent. ; nitrogen, traces. The comjDosition of this 
mixture varies within certain limits, according to its origin ; but 
carbonic acid always predominates. 

Lungwitz, after elaborate experiments with different foods kept in 
closed vessels at the body temperature and with similar agents fed for 
days as an exclusive aliment to oxen provided with a fistula of the rumen 
for j)urposes of collection, found carbonic dioxide the predominating gas 
in all cases, though the proportion varied with the nature of the food. 

Marsh gas varied from 16 to 39 per cent., being especially abundant 
in cases of abstinence. Hydrogen sulphide was found only in traces. 
Oxygen and nitrogen were present in small amount, and were attributed 
to air swallowed with the food. In fermentation the oxygen may be 
completely consumed. 

The abdominal organs, particularly the intestine, are congested, as a 
result of impediment to the venous circulation. The thoracic organs 
exhibit the lesions of asphyxia. 

Pathogeny. Death is due to carbonic acid poisoning, brought about 
in two different ways — viz., progressive asphyxia, caused by inability to 
inflate the lungs, and absorption of carbonic acid gas from the rumen ; 
by virtue of the laws of diffusion, part of the gas contained in the rumen 
passes into the blood. 

The diagnosis is always very easy, and even farm servants may 
recognise the condition. 

The prognosis varies, according to the rapidity with which the 
disease develops. In rapid cases, where the condition is fully estab- 
lished in thirty minutes to one hour, asj^hyxia may be threatened 
from the beginning; but in others, e.g., w^hen the attack follows con- 
sumption of dry food, tympanites may develop slowly, only attaining 
its maximum intensity after a considerable lapse of time. In general 
one may say that tympanites is grave in proportion to the rapidity 
with which the gas is generated. 

Treatment. From the prophylactic point of view, it is necessary to 
avoid suddenly changing animals from dry to green food ; the transition 
should be effected by giving mixtures of dry and green food. 

Curative treatment comprises a large number of methods. 

The latest, and one of the most practical, consists in massage of 
the left flank. The open hand is applied to the left flank and sharply 
pressed directly downwards, care being taken not to injure the parts. 
This manipulation excites reflex action, awakens the dormant contractility 



174 INDIGESTION. 

of the rumen, and leads to restoration of peristaltic movement. The 
gases pass into the omasum and abomasum, or in many cases make their 
way into the oesophagus. The sadden impulses sometimes cause food to 
be returned into the mouth, eructation recommences, and the gas accu- 
mulated in the rumen is partially and progressively evacuated. This 
manipulation is often practised in breeding districts, particularly in the 
case of sheep, in which the disease occurs with the same characters. 
The shepherd fixes the animal between his legs, and, thrusting the 
extended fingers of either hand into the flanks, makes sudden, sharp 
movements, which again set up eructation and get rid of the excess of gas. 

In Germany cold douches are often applied to the flanks. These 
excite vaso-motor action and reflex peristaltic movements, which result 
in eructations and in the evacuation of the rumen. But this is not a 
very practical method, and necessitates arrangements which seldom 
exist on sheep farms. 

The action of massage may be completed by administering stimulants 
like wine, alcohol, or infusions of such aromatic plants as cummin, fennel, 
peppermint, camomile, etc. These act first of all mechanically, by clear- 
ing the terminal portion of the oesophagus. Furthermore, they stimulate 
the mucous membrane of the rumen, causing reflex peristaltic contrac- 
tions, and, as a consequence, circulation of the partly digested food ; 
finally, the majority of them arrest fermentation. 

With the latter object, ether and assafoetida are also given. The use 
of these drugs, however, entails disadvantages, and if the animal has 
finally to be slaughtered renders the flesh unfit for consumption. 

The giving of absorbents is probably most widely practised. The 
ammonia which many of them contain absorbs carbonic acid, thereby 
diminishing the pressure of gas contained in the rumen, and therefore 
the distension of the first gastric reservoirs. Unfortunately this action is 
only temporary, and if the drug is given in too concentrated a form, the 
mucous membrane of the mouth, of the oesophagus, and sometimes even 
of the rumen and reticulum, may be irritated and inflamed, producing 
lesions of stomatitis, pharyngitis, oesophagitis, contraction of the oeso- 
phagus, etc., which after recovery from the acute condition may gravely 
affect the animal's general health. A further drawback is that the flesh 
rapidly acquires an ammoniacal odour. 

Perhaps the best internal treatment consists in administering purga- 
tives such as hyposulphite or sulphate of soda or sulphate of magnesia, 
in doses of 10 to 20 ounces, according to the animal's size, or, in the 
case of pregnant animals, in small frequently repeated doses. These 
check fermentation, and so arrest the evolution of gas, whilst by their 
purgative properties they excite contraction of the gastric reservoirs and 
cause eructation. 



IMPACTION OF THE RUMEN. 175 

None of these methods of treatment, therefore, should be used 
exclusively, but all may be utilised as auxiliaries to mechanical or 
surgical measures, and all should be preceded by the use of the pro- 
bang and puncture of the rumen. 

The first of these operations, the technique of which scarcely requires 
description, is often of little value ; for the solids and liquid contents of 
the rumen being permeated with gases, rise as a fermenting mass into 
the upper portions of the rumen, and continually obstruct the open end 
of the catheter, so that very little gas escapes. 

Puncture of the rumen is much more effective and easier to perform. 
The owner himself often operates with an ordinary pocket knife, some- 
times introducing a couple of fingers or a short length of elder-wood 
tube into the wound thus produced. 

The incision should be made at one stroke, for any hesitation may 
cause the wall of the abdomen to recede from the rumen, which lies 
immediately below. Should gas escape under the skin, emphysema, 
which often extends to the loins and along the quarters, may be pro- 
duced, and may be followed by diffuse subcutaneous suppuration, re- 
sulting from pyogenic germs entering the subcutaneous tissue. 

Large quantities of gas escape from the puncture, sometimes with 
such force as to drive out the canula. The flow of gas then ceases. In 
other cases the tube becomes blocked; because, as the pressure within 
the rumen diminishes, the gases dissolved or mixed with the partially 
digested food are freed, and the whole contents of the rumen become 
converted into an aerated, bubbling mass. Liquid or semi-liquid materials 
ma}^ be ejected to some distance, or may pass between the skin and the 
muscles, or between the walls of the rumen and the abdomen, producing 
various complications, like necrosis, abscess formation, etc. Such acci- 
dents can be avoided by exercising firm pressure with the fingers on the 
tissues sarrounding the canula. 

Even when the rumen has resumed its normal size recovery is not 
certain, and may not occur for several hours, or even several days, after- 
wards. The patients should therefore be kept under observation for 
some time, and it is usually best to leave the canula in place for one or 
two days, and to put the animal on low diet. 

Necrosis of aponeurotic tissues, fistula formation, and local peri- 
tonitis only occur if the instrument is dirty or is introduced in a 
wrong direction. 

IMPACTION OF THE PtUMEN. INDIGESTION AS A RESULT OF OVER-EATING. 

In this condition the rumen is over- distended with food. The 
symptoms are principally due to abnormal fermentation, the peristaltic 



176 INDIGESTION. 

action of the rumen being in abeyance, and the food faiHng to pass to- 
wards the omasum and abomasum. Kumination is generally suppressed. 

The disease usually follows change of diet. When the diet has long 
been restricted, as occurs during years of bad harvests, and animals are 
afterwards set at liberty in rich pastures, they eat greedily, distend 
the rumen Avith large quantities of green fodder, and set up all the 
necessary conditions for this form of indigestion. Similar results follow 
when gluttonous animals are freely supplied with rich food. Working 
oxen also suffer if withdrawn from work and fed with roots, beetroot 
refuse, brewers' grains, or other manufacturing residue for the purpose 
of fattening. These materials can only be absorbed in moderate 
quantity, and the large amount of water, etc., they contain is apt to 
disturb the animal's digestive powers, while owing to its fine state of 
division such food cannot be returned to the mouth for secondary masti- 
cation, and rumination therefore remains incomplete: the food accumu- 
lates in the rumen, distending and eventually paralysing it. This is a 
common result of feeding on semi-liquid pulp, which in order to be 
ruminated should be mixed with rough forage. 

Insufficiency of drinking water is another and more frequent cause, 
especially during the winter, because the ox-herd or cowman is often too 
lazy to give a regular and sufficient supply unless water is laid on in the 
stable itself. The dry food becomes compacted into a mass, which cannot 
be returned to the mouth for rumination. Moreover, less saliva is then 
secreted, and Colin has shown that rumination is impossible when the 
parotid ducts are ligatured. 

Symptoms. As may readily be imagined, the symptoms vary, 
according to the quantity and digestibility of the food swallowed. In 
the first place the appetite falls off : animals suffering from commencing 
indigestion only take part of their food ; later on appetite ceases, and 
with it rumination. Trifling colic sets in, resembling that due to con- 
gestion, and is indicated by unrest, switching of the tail, lifting of the 
hind legs, slight groaning, moving from side to side, and lying down 
and rising at short intervals. The animals seem oblivious of their sur- 
roundings, anxious, and at times semi-comatose. 

When the case has been neglected for several days the animal may 
masticate without having any food in the mouth, and may attempt to 
eructate and to regurgitate food ; but such attempts always fail. It then 
absolutely refuses food, and animals which have eaten large quantities of 
green forage may show tympanites. If called in at this period of the 
disease the veterinary surgeon finds nothing positive except signs refer- 
able to the digestive apparatus. By methodically examining the digestive 
tract, and in particular the stomachs, one discovers during palpation of 
the left flank that the rumen is distended. This is characteristic. By 



IMPACTION OF THE RUMEN. 177 

deep palpation it is even possible to detect marked resistance and a 
certain characteristic firmness resulting from accumulation of food. The 
percussion sounds over this region are dull, and pressure causes pain, as 
though the rumen and peritoneum were inflamed. When the open hand 
is laid flat on the rumen and thrust down^yards, no peristaltic move- 
ment can be discovered. Finally, on auscultation the normal sounds, 
including crepitation, fermentation, and rolling sounds are all absent. 

There are no well-marked general symptoms. Eespiration and 
circulation are hardly accelerated, nor is the artery particularly tense. 

Course and Termination. The course of the disease varies, and the 
condition may be divided into two forms, acute and chronic. The first 
develops in a single day, and may cause death by the same mechanism 
as acute tympanites — i.e., asphyxia or carbonic acid poisoning ; the 
other continues for five, ten, or even twenty or thirty days, according to 
the promptitude with which treatment is undertaken. 

In protracted cases, however, the indigestion itself ceases to be as im- 
portant as the complications. Sometimes spontaneous recovery occurs, 
the food passing away towards the intestine, or even being vomited, 
though the latter conclusion is rare. Kecovery may also follow from 
treatment. If the disease is neglected it may become complicated with 
gastro- enteritis. 

The diagnosis is not very difficult. Indigestion resulting from im- 
paction is distinguished from acute tympanites by its less rapid course 
and by the less marked distension of the rumen (in this case due to solid 
food), and from acute gastro-enteritis by the varying degree of fever 
which accompanies the latter condition. 

Prognosis. The prognosis is always grave, even in cases of acute 
indigestion resulting from eating green food. 

In this case gaseous indigestion occurs as a complication, and neces- 
sitates immediate intervention. The other forms may rapidly yield to 
proper treatment, or, in spite of every care, may give rise to prolonged 
complications. 

Lesions. On post-mortem examination of animals which have died 
of complicated forms of the disease, we find certain lesions peculiar to 
gaseous indigestion associated with impaction of the rumen. 

If death has followed the consumption of root pulps, we see signs of 
poisoning. As a consequence of prolonged stagnation of food in the 
rumen, there follows an exaggerated organic fermentation, whose pro- 
ducts are absorbed through the stomach or intestine and pass into the 
circulation. 

These various fermentations, which may be of the lactic, butyric, 
and even putrid order, produce changes in the mucous membrane of the 
rumen ; wide tracts of the epithelium may be shed, exposing the corium, 

D.C. N 



178 INDIGESTION. 

and producing enormous ulcerations, which in certain cases implicate the 
entire inner surface of the rumen. 

The treatment must be varied, according to the cause, symptoms, 
and immediate complications. When the disease is of an acute type, 
such as that produced by over-gorging with lucern and green food, it is 
best to proceed as in gaseous indigestion, i.e., to puncture the rumen and 
give frequent large doses of purgatives until the stomach and bowels have 
been freely unloaded. The animals should then be kept for some days 
on small quantities of easily digested food, and should be allowed luke- 
warm, mucilaginous drinks. 

When tympanites and impaction occur simultaneously, immediate 
surgical intervention becomes necessary, and gastrotomy may then be 
performed by a very simple method. 

Two loops of cord are passed around the abdomen, one behind the 
hypochondriac circle, the other in front of the angle of the haunch. 
Assistants placed on the right side draw these loops tight, so as to im- 
mobilise the left flank. A bistoury is then thrust directly through the 
walls of the abdomen and rumen. As a consequence of the pressure 
exercised by the ropes, if not of the pressure of gas itself, the food material 
contained in the rumen is often expelled in a powerful stream. As the 
superposed tissues cannot very readily change their mutual relations, the 
author of this suggestion claims that there is little danger either of in- 
fectious materials passing into the subcutaneous connective tissue, or of 
peritonitis ; but this rude treatment can only be resorted to in cases of 
extreme urgency, and it appears by no means without danger. 

Injections of 10 to 15 centigrammes of pilocarpine and 5 to 10 centi- 
grammes of eserine are also useful. 

When impaction of the rumen assumes a less acute form, moderate 
doses of purgatives may be given and repeated daily, or twice a day, until 
the peristaltic action of the rumen is restored and resumes its normal 
rhythm. In certain cases, however, recovery is only apparent. The 
food in contact with the walls of the rumen breaks down, and passes 
away into the abomasum and intestine, while appetite returns. The 
animals then resume feeding, and some days afterwards show all their 
former symptoms. Low diet should therefore always be continued for 
some time. 

In spite of treatment, or in consequence of treatment being too long 
delayed, no improvement may follow. The ingested food is not expelled. 
Putrid fermentation results, auto-intoxication sets in, and the tempera- 
ture rises to 40° or 41° C. Unless gastrotomy is performed death is then 
certain. 

This operation should be undertaken whenever the fever rises to 40° C, 
and two-thirds of the contents of the rumen removed. The rumen should 



IMPACTION OF THE OMASUM (THIRD STOMACH). 179 

not be completely emptied, as there is danger of collapse of its walls. 
Complications in the region of the womid can be avoided by drainage. 

If the operation succeeds, the patients must be placed on very low 
diet or on milk for some days, and should be given lukewarm farinaceous 
drinks, and a little hay of good quality to excite rumination. In old 
milch cows this operation is seldom followed by a satisfactory recovery. 
Apart from the loss of milk, the animal loses condition, refuses to feed, 
and gradually succumbs to exhaustion. 

IMPACTION OF THE OMASUM (tHIRD STOMACH). 

Definition. "A form of indigestion, of which the prominent feature 
is the drying and impaction of the ingesta between the folds of the third 
stomach. It may seem to be a primary disease, but in very many cases 
it occurs as a result of some acute febrile or inflammatory affection." 
(Law's " Veterinary Medicine," Vol. II. p. 123.) 

Synonyms. Dry murrain, clew-bound, fardel-bound, stomach stag^ 
gers, grass staggers, vertigo, chronic dyspepsia, chronic indigestion. 

Causes. Torpidity of the omasum, su23pression of salivary secretion, 
with absence of " waves of liquid floating the finely divided food from the 
mouth or rumen to third stomach, are prime Conditions of desiccation of 
the contents." The third stomach, like the first and second, has no pro- 
vision for liquid secretion, and depends for its supply on constant flush- 
ing by swallowed fluids. Therefore, if feeding and rumination are 
arrested and salivary secretion is suppressed, and if movements of the 
rumen and resulting overflow into the third stomach are checked, the 
ingesta of the third stomach, compressed between its folds, becomes 
drained of liquid and converted into a powder or dry mass. All febrile 
and inflammatory affections tend to this end, and more or less dryino-, 
with impaction of the contents of the omasum, is a constant feature in 
such cases. But in the majority of cases this condition is to be looked 
on as a secondary or subsidiary aflection, and the real disease must be 
sought elsewhere. 

The explanation of the susceptibility of the third stomach in consti- 
tutional troubles has been sought in the source of its innervation. Electric 
stimulation of the vagus rouses the movements of the first and second 
stomachs, but not those of the third. Action of the third stomach is 
excited by stimulation of the spinal cord, and of the symj)athetic nervous 
branches going to the ganglionic cells in the walls of the omasum (Colin 
and Ellenberger). Its nerve supply^coming from a different source, de- 
rangement of its function may occur independently of antecedent disorder 
of the first or second, and its motor supply coming from a source so closely 
related to the vaso-motor centres, perhaps affords some explanation of the 

N 2 



180 INDIGESTION. 

connection of disorders of the omasum with febrile and inflammatory 
diseases. 

Food is an important cause. Impaction of the omasum is a winter 
disease — the time of dry feeding. Dry, fibrous, innutritions fodder, and 
scarcity of water contribute to its production. It attacks cattle in spring 
or autumn on pastures in which fresh grass grows among the dead, 
dried, or withered stems of a previous growth. It occurs when stock 
are fed on corn or corn stalks (maize stalks) affected with smut or ergot, 
or on cereals or grasses similarly damaged, and in both cases especially 
when the water supply is deficient or restricted. 

Sheep and goats, which habitually drink little, suffer less than do 
cattle, which drink freely. 

Other causes. Fermented foods, microbian ferments and their pro- 
ducts, which tend to induce torpidity of the omasum, fever, and lessened 
secretion of saliva, with diminished supply of liquid from mouth or rumen. 

Pericarditis, by causing vascular stasis in the omasum, may induce 
torpor and impaction. 

Lead poisoning paralyses action and favours impaction. Finely 
divided food stuffs — meal and bran — eaten greedily, may pass in quantity 
directly into the omasum and induce impaction. " The most acute and 
fatal forms occur in connection with a sudden change from dry to rich, 
luscious, green food in spring, the unwonted stimulus giving rise to 
general irritation of the whole gastric mucosa, with disordered and im- 
paired function of all four stomachs, but especially of the third. Such 
cases are usually congestive and inflammatory, and the suspension of the 
gastric movements is a grand cause of impaction. In such cases, too, 
the brain or spinal cord, or both, are seriously involved, and the early 
death is preceded by torpor, paralysis, violent delirium or convulsions, 
following largely the type of acute lead poisoning." (Law, loc. cit.) 

The symptoms depend on the degree of impaction, and vary from 
simple, irregular, or suspended rumination to severe gastric and nervous 
disorder. The less acute cases are marked by failure to re-establish 
regular rumination or partial convalescence from fever or inflammation. 
The fever subsides, but the appetite remains capricious, the muzzle dry, 
eyes dull,, spirits low, and breathing accelerated ; the condition is some- 
times accompanied by moaning. Slight tympanites may appear, and 
the contents of the rumen may feel solid, the mouth hot, clammy, and 
foetid. The bowels are constipated, the faeces small in quantity, hard, 
covered with mucus or blood-streaked, and containing particles of undi- 
gested food ; in other cases diarrhoea may set in, to be followed later by 
constipation. Alternations of constipation and diarrhoea may be repeated 
again and again. Exploration by pressure of the closed hand over the 
omasum will give an impression of solid resistance. There may be slight 



IMPACTION OF THE OMASUM (THIRD STOMACH). 181 

shivering, the ears and limbs are cold, the hair is erect in patches, dry 
and lustreless. 

In cases occurring independently of previous disease, diarrhoea may 
be the first symptom observed, the malady being preceded by local irrita- 
tion and congestion ; but this soon gives place to constipation or diarrhoea 
and the symptoms above mentioned. The animal is found lying apart 
on its left side, with its nose in its right flank, the pulse and breathing 
quickened, the eyes congested ; expiration is accompanied by a grunt. 
The patient walks with its back arched and dragging its limbs. The 
appetite may continue, but only in an impaired and irregular form, and 
as rumination ceases grinding of the teeth becomes common. The 
secretion of milk is diminished or arrested, emaciation advances day by 
day. Foetid eructation may be a marked symptom. This form may 
last from ten to fourteen days, and merge finally into paralysis of the 
hind limbs, drowsiness and stupor, or delirium and convulsions. 

"In more acute cases (from sudden access of green food, change of 
water, or ingestion of irritant plants), the affection partakes more or 
less of the nature of congestion or inflammation of the viscus (omasitis), 
and may run a rapidly fatal course " (Law, loc. cit.). The animal is seen 
apart from the herd in a characteristic recumbent position, the eyes are 
red and glassy, the eyelids semi-closed, the patient shows much drowsi- 
ness and stupor, but when raised may still feed in a sleepy, listless 
manner. The bowels are loose or confined, the pulse and breathing 
accelerated, the right hypo-chondrium is firm and tender, and the sound 
of fermentation absent or subdued over the omasum. Soon nervous dis- 
order appears, the eyes glare wildly, the animal seeks relief in motion — 
sometimes in a straight line, sometimes to one side — and being blind and 
unconscious of obstacles, may fall into pits or ditches, knock against 
trees, fences, gates, or buildings, and continue pushing against resisting 
objects, breaking its horns or teeth, and otherwise sustaining injury 
through violent muscular contractions. 

Course. Chronic cases may continue indefinitely, with symptoms of 
poor health, impaired digestion, and gradual loss of condition. After 
death the omasum may contain dried food which the animal consumed 
several months before the attack. 

In cases ending in early recovery there occurs abundant diarrhoea, 
"the faeces are mixed with flattened, dark, solid, and polished masses, the 
impacted ingesta from the omasum. Tympany subsides ; movement 
in rumen and omasum and rumbling in bowels can be heard. Appetite 
returns." (Law.) 

Diagnosis. The condition of the pulse and respiration, and the 
grunting, with expiration may lead to confusion with pneumonia. 

At first there is no fever, tenderness is confined to the right flank ; 



182 INDIGESTION. 

there is an absence of pulmonary crepitation, of pleural effusion, 
and of movement in the rumen and omasum. Signs of gastric and 
intestinal disorder can be detected. 

Lesions. The omasum is gorged — it may be twice its normal size- 
solid, resistant, almost stony. The spaces between the leaves are 
packed with dried food, which, when removed, carries a layer of epi- 
thelium from the mucous membrane. (This (layer on contents) is not 
inconsistent with health.) 

The rumen contains ingesta packed in masses, more or less offensive 
from putrefaction. 

The abomasum is empty of food, but contains much mucus. Its 
mucous membrane is congested. 

The small intestine is red in places, empty and collapsed. 
The larger intestine contains a quantity of dry, glistening pellets, and 
much mucus. 

Treatment follows the lines of impaction of rumen, though the 
response is usually less certain, and always slow^er. Flax-seed tea, 
several bucketfuls per day, will often succeed. 

Epsom and common salts, with sol. ammonite, excite thirst ; liquids 
should be supplied freely. 

In obstinate cases, and in absence of gastric or cerebral congestion, 
20 croton beans, or 20 drops of croton oil, may be added to the purgative. 
Nux vomica stimulates the nervous supply. Enemata may be given 
freely. 

Other remedies, stimulating contractility and secretion, are : Eserine, 
IJ grains ; veratrine, 1 grain ; barium chloride, 10 to 15 grains ; or pilo- 
carpin, 3 grains, hypodermically. 

The patient may be days or even a week without alvine discharge and 
recover. 

If fever and symptoms of gastric congestion appear, a blister may be 
applied to the right side over the omasum. 

Nervous symptoms, such as dilated pupils, blindness, congested 
mucous membrane, hot horns and ears, drowsiness or excitement, are 
combated by applying cold water or ice to poll, etc. 

When free action of the bowels is restored, laxative diet, roots 
(pulped), green food, plenty of common salt, and free access to drinking 
water should be prescribed. 

During convalescence a course of tonics, including nux vomica, is 
advisable to help in restoring normal gastric functions. 

ABOMASAL INDIGESTION. 

Primary indigestion in the abomasum appears to be rare in adults, 
for until the present time no one has given a sufficiently characteristic 



ABOMASAL INDIGESTION. 183 

description of this disease to enable it readily to be recognised. On the 
other hand, it is to be presumed, although final proof has certainly not 
been furnished, that in cases of gaseous indigestion, or of impaction of 
the rumen, the abomasum, whose physiological action is predominant, 
must simultaneously suffer. 

Primary abomasal indigestion, on the contrary, is common in young 
animals before weaning, so that the condition has been given the name 
of "milk indigestion." It could not very well be otherwise, for the 
abomasum is the only one of the gastric divisions which in ruminants 
is active during the first few weeks of life. At this period it is larger 
than the other gastric reservoirs ; and the rumen, the reticulum, and the 
omasum do not undergo great development till weaning begins. 

Causation. Milk indigestion attacks young animals under varying 
conditions. 

In animals suckled by the mother the disease rarely occurs, but yet 
when the mothers are good milkers, like the Flemish, Norman, Jersey, 
and Holland breeds, and when there is too long an interval between the 
feeds, calves, which are naturally greedy, and in addition are hungry, are 
apt to take too large a quantity of milk — in fact, they often gorge to the 
fullest possible extent. Owing to its over-distended state the abomasum 
either fails to secrete sufficient of the rennet ferment necessary for 
coagulating the milk or secretes an insufficiently active ferment. The 
first stage of digestion remains incomplete, giving rise to so-called 
"milk indigestion." 

When the cows are employed in ploughing, etc., or in drawing carts, 
not only are the calves fed at long intervals, but the milk is not always 
of proper chemical composition even in the udder. As a result of 
work, fatigue, over-exertion and irregular feeding, the cow's yield of milk 
for the time is less digestible than the normal supply, or may even prove 
irritant to the calf's stomach. Milk indigestion is thus set up. 

When the cows are fed on factory waste, like beetroot-pulp or brewers' 
grains, toxic or irritant products may even find their way into the milk, 
which then irritates the little creature's abomasum and produces gastric 
indigestion. Just as in the production of congenital alcoholism in man, 
the young animal is then ingesting, unknown to those responsible for 
its well-being, chemical substances which produce various pathological 
changes. 

But milk indigestion is commonest of all in calves fed by hand. The 
food usually given is a mixture of milk from the previous night, and 
skim milk or even butter milk. It contains lactic ferments and various 
microbes, some capable of producing toxic principles. 

When swallowed and brought directly in contact with the mucous 
membrane these cause abomasal indigestion. 



184 INDIGESTION. 

Symptoms. Soon after feeding, the little animal appears dull and 
somnolent, and shows moderate abdominal pain, suggesting trifling 
colic. 

This stage is soon followed by nausea ; the breathing and the heart's 
action become rapid, vomiting efforts are made, and finally milk, in 
the form of firm or partially softened curds, depending on the time which 
has elapsed since the last feed was taken, are vomited. The quantity 
ejected varies. Pressure over the right side of the abdomen produces 
pain, and tympanites of the abomasum may sometimes be detected on 
percussion. 

The sensitiveness and gaseous inflation are confined to the middle 
and lower zone of the hypochondrium. Soon after vomiting the animal 
begins to improve. The patient seems brighter, relief is very marked, 
and in some cases proves permanent; but more frequently a certain 
degree of depression persists, the mouth emits a sourish odour, and for 
a time the appetite remains poor. This temporary irritation of the 
abomasum has a tendency to become permanent ; or even to extend to 
the intestine, in which the conditions appear more favourable to the 
development of micro-organisms than do those in the stomach. In- 
digestion then becomes complicated with diarrhoeic enteritis. 

The diagnosis presents no difficulty. 

The prognosis is not serious, provided that the young animals are 
carefully attended to ; but such complications as diarrhoeic enteritis may 
become very grave if neglected. 

The treatment. To prevent recurrences : 

(1) The periods of feeding should be regulated ; 

(2) The cows should not be worked, or should be worked as little as 
possible ; 

(3) Mixed milk, or milk which has already undergone lactic or other 
fermentation, should be avoided. 

If the calves must be reared by hand, the mixed milk should at least 
be boiled or relatively pasteurised by heating to 70° or 80° C, and the 
buckets used for feeding should be kept scrupulously clean. These 
precautions become absolutely necessary when diarrhoea exists amongst 
the calves. Curative treatment consists in placing the animals on low 
diet for two or three days after the attack of indigestion, or in giving 
them boiled milk diluted with from one-half to two-thirds of boiled 
water. 

The addition of a mild saline purgative like sulphate of soda, in doses 
of one-half to three-quarters of an ounce, usually ensures a cure. 
Infusions of lime-tree flowers, peppermint, camomile, etc., may ad- 
vantageously be used to replace boiled water in diluting the first 
foods. 



ACUTE GASTRIC INDIGESTION IN SWINE. 185 

ACUTE GASTRIC INDIGESTION IN SWINE. 

The causes comprise putrid food, swill, spoilt turnips, jDotatoes, 
apples, succulent vegetables, frozen food, and the admixture of caustic 
alkaline powders (used in washing table dishes) with the swill. Indi- 
gestible matters — hoof, horn, hair, bristles, tree bark, etc. — when not re- 
jected by vomiting, cause gastritis and indigestion. Lastly, medicinal 
substances and poisons, paint and lead, sometimes produce the disease. 

Among the symptoms may be mentioned dulness, arching of the 
back, standing with the feet brought together, erection of the bristles, 
hiding under the litter, grunting, uneasiness, shifting from place to 
place, tenseness of the abdominal wall, borborygmus ; these may be 
followed by diarrhoea and recovery. Speedier relief is afforded by 
copious vomiting of irritant matters. 

The treatment should commence with the free administration of 
emetics. To combat alkaline poisoning vinegar may be given, followed 
by a laxative. Prophylaxis calls for greater care in feeding. 



CHAPTER V. 

ACUTE INFLAMMATION OF THE GASTRIC COM- 
PARTMENTS- 

RUMENITIS-RETICULITIS -GASTRITIS. 

Causation. Acute primary inflammation of the first gastric reser- 
voirs, viz., the rmiien and reticnhun, is not common. It sometimes 
accompanies such infectious disorders as foot-and-mouth disease, gan- 
grenous coryza, etc., but then constitutes an added phenomenon which 
should be studied along with the original disease itself. Eumenitis or 
reticulitis may however follow the ingestion of irritant foods or plants, 
of very hot liquids, and more frequently still of unskilfully compounded 
medicines. In such cases the mucous membrane is directly attacked, 
and pathological congestion, infiltration, and desquamation may follow, 
or even vesicles and ulcerations may rapidly be formed. 

Symptoms. Inflammation of the rumen or reticulum is announced 
by loss of appetite, suspension of rumination or of regular peristalsis, 
sUght tympanites, and particularly by excessive sensitiveness to palpa- 
tion. This sensitiveness is general, but is more specially marked in 
the left lower third of the abdominal cavity, and in the retro-ensiform 
region which corresponds to the position of the reticulum. Moderate 
fever is present. 

These symptoms, which indicate the gravity and intensity of the 
inflammation, may persist, become aggravated, provoke vomiting from 
the rumen, and leave as a legacy motor dyspepsia, or even more serious 
consequences. On the other hand, they may progressively diminish 
and disappear for good. 

Lesions. The lesions comprise hypersemia of the walls of the rumen 
and of the mucous membrane, extensive local exfoliation of epithelium, 
and sometimes true ulceration of the mucous membrane. 

Diagnosis. The diagnosis is based on the exceptional sensitiveness of 
the gastric compartments on palpation, and also on the history, provided 
reliable information can be obtained. 

Prognosis. The prognosis should be reserved, because it is never 
possible to foretell whether acute lesions may not give place to chronic 



RUMENITIS — RETICULITIS — GASTRITIS. 187 

disease, Avhich, though apparently unimportant, may terminate in grave 
consequences. 

Treatment. Owing to their local action demulcent drinks and teas 
are indicated. Cooked food is useful, because it makes little demand on 
the digestive powers ; steamed hay and farinaceous substances are 
given, both on account of their nutritious qualities and of the slight 
local irritation they cause \vhen swallowed. 

Lukew^arm drinks and saline laxatives, such as the sulphate of soda, and 
carbonate of soda or Carlsbad salt in small doses of 1^ to 2 ounces, seem 
most useful in combatting the reflex atony of the digestive compartments. 

Inflammation of the omasum, like that of the rumen and reticulimi, 
occurs as a secondary phenomenon in conditions like rinderpest, Texas 
fever, foot-and-mouth disease, anthrax, and gangrenous coryza (malig- 
nant catarrh) ; but primary inflammation is much rarer even than that 
of the rumen and of the reticulum. 

This is accounted for by the deep position of the omasum, w^hich is 
thus sheltered from external violence, early contact wdth irritant foods and 
from the effect of chills, etc. It can only become inflamed by the prolonged 
action of irritant food and drink, wdiich have already produced lesions in 
the rumen and reticulum ; or as a consequence of the prolonged stagnation 
of dry food in cases wdiere animals have been deprived of w^ater. 

Under these conditions inflammation of the omasum develops slowdy, 
and from the clinical point of view^ is identical with what was formerly 
knowm as obstruction of the omasum. Obstruction or impaction is 
probably much rarer than has been stated, in so far at least as it con- 
stitutes a primary condition, for in the great majority of cases it is 
consecutive to impaction, infxammation of the rumen, or inflammation 
of the abomasum. Obstruction of the omasum, w^hich w-as formerly 
invoked in all doubtful and ill-defined cases of digestive disturbance, 
seldom^ occurs as an isolated disease. 

It has been suggested that the omasum, being supplied with nerves 
solely by the sympathetic system, and provided with a relatively weak 
muscular coat, was more susceptible than the other reservoirs to the 
reaction of abdominal reflexes, and therefore more subject to inflam- 
mation, indigestion and obstruction. We do not hold that view, because, 
as a result of its general situation and the position of its orifices of 
communication, this compartment is easily able to expel its contents 
so long as they are liquid. Its function appears chiefly to be to complete 
the trituration of food after rumination. 

We do not consider that inflammation of the omasum never occurs, 
for w^e are well aw^are of the contrary, and that the inflammation assumes 
a subacute course and is accompanied by stasis of the semi-digested food 
between the mucous leaves which partly fill the cavity. We simply wish 



188 ACUTE INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

to emphasise the view that the condition is not a primary and isolated 
inflammation. 

Symptoms. The symptoms are always vague and very difficult 
clearly to define. 

Inflammation of the omasum is indicated by relative loss of appetite, 
marked thirst, general atony, and diffuse and vague sensitiveness in the 
inferior half of the right hypochondrium (zone of the asternal ribs). 
There are no pathognomonic symptoms. 

Obstruction has also been described as accompanied by loss of 
appetite, constipation, the passage of black, coated, foetid and sometimes 
blood-streaked faeces, symptoms of chronic tympanites with foetid eructa- 
tions and sometimes vomiting. These sometimes accompany hydrochloric 
acid dyspepsia, a form of chronic gastritis, and, from our standpoint, the 
stagnation of food in the omasum is only secondary. We therefore 
interpret the facts in quite a different manner, and believe that only by 
a rational and physiological interpretation of the symptoms observed can 
one diagnose the condition. 

Diagnosis. The diagnosis of inflammation of the omasum can only 
be made by a process of exclusion ; and although we are admittedly 
dealing with a condition secondary to disturbance of the rumen and 
reticulum, or on the other hand consecutive to inflammatory states or 
to modifications in the secretion of the abomasum (dyspepsia), the 
diagnosis does not present insuperable difficulties. 

The prognosis is only grave when the primary acute or chronic 
conditions of the other gastric compartments are serious. 

The lesions comprise abnormal vascularity of the mucous membrane 
and desquamation, and even gangrene, of the leaves. The partially 
digested food is not passed on, becomes dry and hard, and in time 
aggravates the local condition. 

The treatment does not essentially differ from that of other gastric 
inflammations. The object to be attained is to evacuate as completely as 
possible, not only the omasum, but all the gastric reservoirs, for which 
purpose one may freely administer demulcent drinks — linseed gruel, 
bran mashes and lukewarm liquids containing laxatives. At first such 
alkaloids as arecolin and pilocarpine may be subcutaneously injected 
to ensure energetic and speedy evacuation. 

Later on slightly stimulant aromatic infusions, like infusions of sage, 
pejDpermint, hyssop, thyme, etc., stimulate the functions of the stomach 
and hasten the return of normal conditions. 

ACUTE GASTRITIS. 

The term " acute gastritis," sometimes " gastro-enteritis," is used 
in bovine pathology to indicate inflammation of the abomasum. If this 



ACUTE GASTRITIS. 189 

inflammation is confined to the superficial epithelial layers it is defined 
as superficial catarrh of the abomasum ; if, on the contrary, it extends to 
the deep epithelium of the gastric glands and to the mucous corium, it 
is termed deep-seated gastritis. 

Clinically it is impossible to make these distinctions. We simply 
recognise degrees of gravity, and only in this way can one diagnose 
acute gastritis, phlegmonous gastritis, ulcerative gastritis, etc. 

Causation. The abomasum frequently becomes inflamed as a conse- 
quence of irritant foods, apart altogether from lesions of the rumen or 
reticulum, the mucous membrane lining the abomasum being so much 
more delicate than that of either of the two first compartments. 

Irritant plants, parasites, acid drinks, very cold water, certain acid 
or toxic industrial residues like mouldy brewers' grains, fermented 
vegetable pulp, decomposed beet, etc., and mouldy or spoilt forage of 
any kind may all produce acute gastritis. 

Intense feeding — i.e., feeding with farinaceous materials, with large 
quantities of beans, roots, peas, given regularly — may also cause gastritis 
by overtaxing the functions of the organ. Frozen or fermented roots 
and sudden changes in feeding produce similar results. Chills have also 
been blamed, but it is probable that they only act as favouring causes. 

Symptoms. It is necessary to consider these very carefully in order 
to arrive at a correct diagnosis. 

Inflammation of the abomasum is attended with moderate fever, 
diminution in aiDpetite, irregularity in rumination and some tension of 
the rumen, without, however, true tympanites. 

At first the bowels are constipated, but in time foetid diarrhoea sets 
in. Examination of the digestive apparatus on the left side and in the 
right posterior abdominal region reveals nothing abnormal, but pressure 
over the lower portion of the abdomen and along the cartilages of the 
right hypochondriac region produces, on the contrary, well-marked pain. 
This region corresponds to the position of the abomasum. 

The conjunctiva appears reddish yellow, as in most visceral inflam- 
mations. 

Some authors have described attacks of extreme excitement, but 
these are no more pathognomonic than is grinding of the teeth, which 
is a constant symptom, or the metallic sound noted on auscultation 
of the rumen. This sound occurs in all cases of inertia of the rumen, 
and indicates distension and emptiness of the viscus (acute peritonitis, 
chronic adhesive peritonitis, inflammation of the reticulum as a conse- 
quence of the presence of foreign bodies). 

Dull colic and groaning are not uncommon. Finally, Thierry and 
others have all mentioned an alliaceous smell of the eructations as 
pathognomonic. 



190 ACUTE INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

Acute gastritis develops regularly in ten to fifteen days, after which 
the symptoms diminish and disappear, giving place to normal health. In 
grave cases, despite proper treatment, acute gastritis more frequently 
ends in a chronic condition, finally leading to gastric atrophy, and the 
insufficient secretion of hydrochloric acid, with all the consequences of 
these conditions. The glands of the stomach degenerate ; the secretion 
becomes abnormal and dyspepsia is set up. 

Diagnosis. The diagnosis is rather difficult, for the condition is very 
apt to be confused with primary dyspepsia, or with inflammation of the 
gastric compartments. It might also be mistaken for acute enteritis of 
the first part of the small intestine ; but as gastritis is very often compli- 
cated with duodenitis, such a mistake is without serious consequences. 

Prognosis. The prognosis is grave, not because death is a frequent 
termination, but because the disease very often leads to chronic incurable 
lesions. 

The lesions consist of congestion of the vascular network of the 
mucous and subepithelial coats, serous infiltration of the corium and 
submucous connective layers, desquamation, and later in excessive 
proliferation of the epithelium. 

When the inflammation is deep seated the epithelium of the gastric 
glands becomes swollen and cloudy, and undergoes a kind of atrophic de- 
generation. In very grave cases, petechiae, superficial capillary haemor- 
rhages, and slight ulceration may be noted. The mucous folds are 
always thickened and infiltrated. 

Treatment. In cases of gastritis or acute gastro-duodenitis mode- 
rate bleeding (three to four quarts) and local stimulation were formerly 
recommended. This practice certainly has its advantages, provided it is 
not pushed to excess. Sinapisms give good results, but as they must be 
left in position for a considerable time, it is often better to apply vesicants 
over the lower right hypochondriac region. At first purgatives are useful, 
because they unload the digestive tract, arrest the organic fermentation 
which results from stagnation in the movement of food along the alimen- 
tary tract, and diminish the tendency to intoxications or infections. 

At a later stage small doses of laxatives and bicarbonate of soda should 
be given daily, the diet being of an emollient character, and consisting of 
milk, starchy or farinaceous foods, and small quantities of good hay. 

Linseed, bran, cooked grain, decoctions of pellitory, barley and 
various cereals may also be administered with advantage. 



CATAERHAL GASTRITIS IN SWINE. 

Definition. Inflammation of the gastric mucosa, with muco-purulent 
discharge. 



ULCERATIVE GASTRITIS. 191 

The causes comprise irritants, fermented or putrid swill, decorbposed 
food, excess of brine, alkalies (washings from table dishes, hotels, etc.), 
gastric parasites. 

The condition occurs also in hog cholera, SAvine plague, rouget, etc. 

The chief symptoms are : Inappetence, vomiting, uneasiness, colic, 
consti^^ation or diarrhoea, fever, stiffness, tense and tender abdomen, 
arched back, frequent grunting, limpness of the tail. Sudden vomiting 
may bring about a rapid recovery. 

Treatment calls for a complete change of food, which may include 
freshly cooked roots, linseed or meal, butter milk, boiled milk, etc. 

As an emetic 30 grains of ipecacuanha may be given. Constipation 
can be relieved by a dose of calomel or jalap. If diarrhoea is persistent 
small doses of grey powder should be given, and to combat the irritation of 
the gastric mucous membrane bismuth subnitrate is also useful. 

The piggery should be cleansed and disinfected, and the litter frequently 
changed. 

ULCERATIVE GASTRITIS. 

Ulcerative gastritis (ulcer of the abomasum) is recognised after death, 
but hitherto it has been impossible to so clearly identify the symptoms as 
to permit of diagnosis during the animal's life. In has been found 
after death in adults and in calves (Ostertag). 

Causation and Pathogeny. The cause of gastric ulceration is 
decidedly obscure, though we know that certain forms occur during 
infectious diseases like cattle plague, foot-and-mouth disease, gangrenous 
coryza, and as a consequence of certain direct local infections ; other 
forms result from the administration of drugs; and finally some are of 
secretory origin. 

In human medicine at the present day there is a tendency to refer 
the development of round ulcer and ulcerative gastritis to the secretion of 
an excess of hydrochloric acid. Probably the same cause may be at work 
in domestic animals, but the proof has not yet been given. 

With regard to the pathogeny, the theories of embolism or of throm- 
bosis of capillary vessels find favour with few^ authorities at the present 
day. Yet these explanations are logical enough, for if we prevent 
physiological irrigation of any given part, it is possible to conceive that 
ulcer formation may follow from auto-digestion, i.e., from the simple 
action of the gastric juice on a surface which is no longer protected. 

The theory of microbic origin has been advanced ; but although it may 
be accepted in relation to the intestine, where the most varied organisms 
abound, it is scarcely so applicable to the stomach, in which acidity is 
always very marked and must exercise a very energetic antiseptic action. 
In sucking calves, however, this theory appears the most plausible. 



192 ACUTE INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

It is quite certain that ulceration may result from the unwise use 
of drugs, like tartar emetic or arsenious acid, especially if these be 
administered for long periods ; but such ulceration always occurs at the 
same points, viz., at the deepest portion of the rumen, reticulum, or 
abomasum. 

On the other hand, ulceration due to secretory disturbance occurs at 
different points, and the figure opposite shows that the mucous folds 
themselves may be injured and perforated. 

Lesions. Ulceration of the abomasum varies in severity. The case 
referred to showed excavated ulcers from the site of which a portion 
or the whole of the epithelium and glandular layer had been shed ; true 
round ulcers, which had destroyed the entire depth of the mucous mem- 
brane and had produced chronic inflammation and sclerosis of the muscular 
layer ; and finally perforations resembling cleanly punched-out holes. 

The Symptoms are those of a mild form of ordinary acute gastritis, 
without marked fever, and without special injection of the conjunctiva. 
The appetite is diminished and irregular, but more as a consequence of 
excessive reflex sensibility of the injured organ than from absence of 
hunger. This excessive reflex sensibility of the abomasum causes relative 
or absolute gastric intolerance, so that only a small amount of the food 
ingested passes towards the intestine. 

Absolute intolerance on the part of the abomasum may even occur, 
as in a case described by Moussu in 1895, which produced a very special 
form of impaction of the rumen, absolutely different from primary 
impaction. 

Intolerance of the abomasum for food already ingested and rumi- 
nated may extend to the omasum. Peristalsis of the rumen then ceases, 
and slight tympanites occurs. The most ciiaracteristic condition is the 
existence of obstinate constipation. If ulceration takes place without 
producing any important vascular lesion, which, however, is rare, the 
fseces are hard and coated, but without other peculiarity ; if, however 
(and this appears to be the rule), local haemorrhage occurs, the extrava- 
sated blood is modified by the gastric and intestinal juices, and the faeces 
appear of a black, tarry colour. This coloration is very significant, 
and differs from that produced by the bile. It occurs only in gastric 
haemorrhage, and at intervals. 

Diagnosis. The diagnosis of gastric ulcer is difficult, and can only be 
arrived at with confidence when the above-mentioned coloration of the 
faeces can be detected. 

Prognosis. From an economic standpoint the prognosis is grave. The 
patient may recover ; the ulcers may heal, but cicatrisation is always pro- 
longed, and as, on the other hand, the glandular apparatus of the abomasum 
is generally more or less injured, complete recovery is impossible. 



ULCERATIVE GASTRITIS. 



193 




Fig. 70. — Ulcerative gastritis. 1, Typical round ulcer; 2 and 3, ulcers perforating 
folds of the abomasum ; 4, 5, and 6, old-standing ulcers with sclerosis of the walls 
of the abomasum and adhesive perigastritis. 



D.C. 



194 CHRONIC INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

Treatment should be directed towards checking haemorrhage, dimin- 
ishing intolerance to food, and assisting the heaUng of the lesions. 
These objects are facilitated by prolonged complete rest in the stable, by 
injecting ergotine, or, '7 per cent, saline solution, at the time when the 
hemorrhage occurs, and, if possible, by placing the animals on milk diet 
or on emollient food, like gruels, emollient infusions, barley, milk, cooked 
roots, etc. 

Stimulation over the region of the abomasum is also of value. At a 
later stage, when the acute symptoms have diminished, Carlsbad salts, 
in doses of 1 to 2 ounces per day, can be given. Bicarbonate of soda is 
also of considerable value. 

CHRONIC TYMPANITES. 
Chronic Indigestion — Obstruction of the Abomasum — Chronic Gastritis — 

Dyspepsia. 

Among pathological conditions of the stomach in ruminants a 
certain number are clinically marked by one constant symptom, viz., 
chronic tympanites, a fact which was formerly recognised as indicative 
of chronic indigestion. 

It is evident that such titles have only the significance accorded 
them, and the term chronic indigestion used only to mean that gastric 
digestion was badly performed, and that the condition was more or less 
permanent. It being granted, on the other hand, that the term in- 
digestion is used to characterise temporary conditions during which 
digestion is suspended, and produces immediate disturbance, it would 
appear that the term gastric dyspepsia is more exact and more in 
conformity with the present state of our knowledge of general physio- 
logy. In studying this question it is clear a number of facts still 
require explanation, for, as has been ^^reviously indicated, we know 
almost nothing concerning the variations in the chemical phenomena 
of gastric digestion under different morbid conditions ; nevertheless, the 
dominant fact, the imperfect or irregular digestion, is easily appreciable. 
Future discoveries will no doubt enable us more exactly to differentiate 
several dyspeptic conditions due to chemical or mechanical causes and 
with or without anatomical lesions. At present it is sufficient to indicate 
the limits of inquiry. 

Causation. The sym|)tom of chronic tympanites accompanies a 
great number of very different conditions — some due to disease of the 
digestive tract itself, others to general diseases or lesions of neigh- 
bouring parts. In the latter cases the tympanites is only indicative 
of secondary dyspepsia ; in the former, on the other hand, the dyspepsia 
is primary. 

Secondary dyspepsia occurs very commonly during tuberculosis. 



CHRONIC TYMPANITES. 195 

diseases of the liver, subacute or chronic peritonitis, gestation, lesions 
of the mediastinum, etc., etc. 

(a) Secretory or Chemical Dyspepsia. In primary dyspepsia it is 
impossible to discover any lesion sufficient to explain the disturbance. 
Chronic tympanites, for instance, follows prolonged consumption of 
rough or bad food (in years when forage has been scarce or winter 
food has been lacking), and too short a supply of water for weeks in 
succession. It also occurs as a consequence of acute inflammation of 
one or other of the gastric compartments — rumenitis, reticulitis, gas- 
tritis. Sometimes it assumes an insidious, slow, progressive form, 
without any apparent cause whatever. 

In these various conditions, the mucous membrane of the gastric 
compartments suffers from the deferred results of the bad feeding 
or want of water. Its secretory powers and anatomical structure be- 
coming modified, it is no longer able regularly to elaborate the juices 
necessary for digestion, and chronic indigestion, imperfect digestion, or 
dyspepsia result. Similar results follow acute inflammation of the 
omasum, reticulum, or rumen. Integral repair becomes impossible. 
Anatomical injury is done, disturbance of secretion follows, and dys- 
jDepsia is a necessary consequence. 

(b) Motor Dyspepsia. Finally, it would appear that general bad 
health, abstinence and exhausting work, may produce a form of dys- 
pepsia, unconnected with secretory disturbance, but resulting from 
mechanical disturbance due to general enfeeblement and to atony of 
the muscular walls of the gastric compartments. The rumen ceases 
to perform its work of mixing the food, the reticulum also acts badly, 
and the abomasum receives imperfectly prepared material. The result 
is what might be described as motor dyspepsia, in opposition to those 
forms which are of chemical origin. 

The condition may vary in degree, peristalsis being diminished (one 
contraction every two or three minutes instead of two per minute), or 
being simply intermittent and occurring only for a few hours during 
the day, or finally being altogether suppressed. Suj^pression is never 
absolute, but atony may be so marked that the mixing of the food is 
very imperfectly performed. 

Symptoms. The most constant symptom present in all dyspeptic 
conditions is chronic tympanites, indicated by a certain degree of 
tension or by permanent dilatation of the rumen. 

Kumination is impeded and irregular, the distended rumen loses its 
power of contraction, and no longer causes eructation nor passes gas 
into the intestine. It becomes progressively inert, whether the inertia 
be primary and occur suddenly, as a result of some particular condition 
of the sympathetic system (motor dyspepsia), or secondary and of slow 

o 2 



196 CHRONIC INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

development in consequence of disturbance in the gastric secretions and 
of abnormal organic fermentation (secretory dyspepsia). 

This symptom of tympanites is always accompanied by irregularity, 
diminution, and frequently also by depravity of appetite. 

Wasting occurs, but to a very varying degree, according to the 
nature of the primary condition and the method of feeding. 

These general symptoms are accompanied either by constipation or 
by diarrhoea ; and as stagnation of food leads to fermentation, which 
always forms products differing from those of normal digestion — toxic 
materials in fact — a chronic auto-intoxication results, which in its 
turn, if not remedied, becomes a cause of irritation, and aggravates the 
bad general condition. 

In many cases fever is absent, except during the final complica- 
tions, in animals in the last stages of wasting; but some signs always 
exist on which the diagnosis may be founded. 

The most frequent clinical type of these dyspeptic conditions is 
motor dyspepsia, consisting in relative atony of the rumen without 
disturbance in the secretion of the gastric mucous membranes. 
Luckily, this is the most easily curable form, and is only marked by 
distension, dulness and constipation. 

Dyspeptic diseases of secretory origin are little understood. Their 
essential causes have been badly described, and their clinical symptoms 
are ill-recognised. 

We cannot prove w4iether the forms said to be due in man to excess 
of hydrochloric acid and insufficiency of hydrochloric acid really occur 
or are Avell defined in domestic animals : nor are we better informed as 
to the exact part played by the organic acid of fermentation (lactic, 
butyric, acetic acid, etc.) ; but the most complete investigations which 
have yet been made justify our supposing there is some parallel. 

Moussu described primary ulcerative gastritis in 1895 ; and as this 
form is almost certainly associated with excess of pepsine, the occur- 
rence of an excess of hydrochloric acid also seems possible, the 
more so as the symptoms noted resemble the general symptoms of 
that condition — preservation of appetite and of the motor power of 
the rumen, accumulation of food in the rumen as a consequence of 
reflex intolerance of the abomasum, constipation, and vomiting. 

In addition to these two morbid conditions, a third occurs with 
some frequency. It is characterised by chronic tympanites, alimen- 
tary diarrhtt3a (the food being badly digested), and progressive wasting. 
This condition seems due to an insufficiency of hydrochloric acid, 
brought about by chronic gastritis, the epithelial cells of the mucous 
membrane appearing incapable of producing sufficient hydrochloric 
acid for digestion. 



CHRONIC TYMPANITES. • 197 

Diagnosis. In the present state of our knowledge regarding diges- 
tion in ruminants the precise diagnosis of these pathological conditions 
must always remain difficult ; but it is indisputable that with the above 
grouping of symptoms we are more likely to succeed than by confining 
ourselves to the diagnosis formerly common, viz., that of chronic tym- 
panites or chronic indigestion. 

The difference between primary and secondary dyspepsia should always 
be borne in mind, and careful examination will often reveal the special 
condition which has served as the point of departure for gastric disturb- 
ance. Thus generalised tuberculosis, or tuberculosis of the liver or 
mediastinum, should always be. sought for, and the possible existence 
of such conditions of the liver as echinococcosis, cancer of the bile 
ducts, tumours, etc., and diseases of the kidneys should be borne in 
mind. The influence of gestation, which so frequently causes gastric 
disturbance complicated with albuminuria, should never be over- 
looked, and in these secondary forms of dyspepsia the determining 
cause, and not the objective symptoms should receive chief attention. 

Prognosis. The prognosis of secondary forms of dyspepsia varies 
with the gravity of the primary disease. The prognosis of primary 
dyspeptic conditions varies greatly, and that state in which hydro- 
chloric acid is too sparingly secreted is certainly the gravest. 

Lesions. The lesions have not been carefully studied, but it is 
probable that in many cases they might afford a key to the symptoms 
noted. Like all mucous lesions, they are difficult to demonstrate 
histologically. Infiltration and thickening of the mucous corium and sub- 
mucous layers have been described. Such lesions indicate nothing ; but 
in some cases new growths have been found in the gastric compartments 
or contractions about the pyloric orifice, the essential importance of 
which cannot be doubted. 

Treatment. If our knowledge is still insufficient to enable us pre- 
cisely to diagnose what w^e have termed " gastric dyspepsia," or what is 
still currently described as " chronic dyspepsia," the difficulty is even 
greater when attempting to lay down lines of treatment, because of the 
lack of known facts and- the want of a base for reasoning. Thus we find, 
without being able to explain w^hy, that some prescribe tartar emetic, 
others rapid and energetic purgatives, others, again, laxatives ; whilst 
German authors, apparently without any justification, recommend oil 
of turpentine. It seems to us, however, that one might do better than 
this and attempt to lay down some rational indications for treatment. 

(a) In cases characterised only by chronic tympanites, without diar- 
rhoea, without manifest constipation (motor dyspepsia), and without any 
other apparent organic disturbance, drugs calculated to stimulate peri- 
stalsis of the rumen seem indicated. The most promising comprise 



198 CHRONIC INFLAMMATION OF THE GASTRIC COMPARTMENTS. 

ipecacuanha in doses of 1 to 2 drams per day, tincture of nux vomica in 
similar doses, powdered nux vomica in doses of 45 to 75 grains, and 
laxatives like Carlsbad salts in doses of 8 to 10 drams. 

Little by little peristalsis returns, becomes regular, and the chronic 
tympanites disappears for good. This is frequently the case during 
gestation, when the condition simply consists in motor dyspepsia without 
ansemia. 

(b) If, on the contrary, chronic tympanites is accompanied by 
constipation, and the faeces are hard or, as is usually the case, covered 
with mucus, suggesting the probability of excess of hydrochloric acid, 
salines are indicated — not to the point of producing purgation, which 
would not lead to any lasting improvement, but still as laxatives, con- 
tinued daily for ten, fifteen, or twenty days, or, if necessary, even longer. 

Carlsbad salts in doses of 8 to 10 drams, or one-ounce doses of sulphate 
of sodium associated with 2J drams of bicarbonate of potash after each 
meal, are to be recommended in preference to bicarbonate of soda alone, 
because they act on the secretions, on the muscular system, and also on 
the liver. 

(c) Finally, when chronic tympanites is accompanied by diarrhoea, 
a condition which usually indicates insufficient secretion of hydrochloric 
acid, the administration of that acid tends to arrest or check organic 
fermentation and to facilitate digestion in the abomasum by supple- 
menting the diminished physiological secretion. The dosage is an 
important point. At first small quantities should be given, 2J drams 
per day, divided into two doses and freely diluted in the drinking water ; 
but this amount may, if necessary, afterwards be doubled or trebled. The 
drinking water is not rendered irritant by these doses, for it is admitted, 
and Moussu has confirmed the fact by analysis, that the quantity of 
HCl in the gastric juice may rise as high as '2 to '3 per cent. Chloride 
of sodium, the excito-secretory action of which on the gastric mucous 
membrane is well known, may be given for long periods in doses of 
1 to IJ ounces per day. 

In these various chemico-pathological states the food should receive 
the closest attention. The forage, which should be good, may be supple- 
mented by the addition of cooked roots, demulcent drinks, and, if 
possible, milk. 

GASTRIC DISTURBANCE DUE TO FOREIGN BODIES. 

* 

These morbid conditions are extremely complex, but the facts that 
they are due only to one cause, and that they possess certain symptoms 
in common, permit of a certain grouping. It would obviously be 
illogical to speak of traumatic indigestion of the rumen, reticulum, and 
abomasum, as has been done in more than one book on this subject ; for 



GASTRIC DISTURBANCE DUE TO FOREIGN BODIES. 199 

the gastric disturbances described below should be considered as 
complications, and not as diseases. 

Causation. In young animals foreign bodies may be composed of 
hairs, wool, bristles, cotton, and clover hairs. 

Hair balls are common in the ramen, and are sometimes met with in 
the fourth stomach. They cause irritation, indigestion, sometimes pyloric 
obstruction, dilatation, and eventually death. 

Wool balls in lambs, bristle balls in young pigs, cause much gastric 
irritation. Cotton balls occur in lambs fed on cotton-seed cake ; the fibre 
constitutes a foreign body. The hairs of clover leaves may form a ball 
in the abomasum of lambs. 

Under the influence of depraved appetite animals of the bovine 
species consume, apart from their regular food, the most varying sub- 
stances, such as linen, fragments of wood, nails, stones, gravel, sand, etc. 
Moreover, forage, even when of good quality, often contains foreign 
bodies like nails and pins (when the fields are near factories), sewing or 
knitting needles (when the animals are looked after by women), frag- 
ments of iron wire derived from bales of compressed forage, etc., etc. 
The ingestion of such objects is folloAved by various consequences, which 
may be studied in three divisions, in the first of which the foreign object 
is soft in character, in the second is blunt at one extremity and pointed 
at the other, and in the third is pointed at both ends. 

(1.) Soft objects. The movements of the rumen, the warmth and 
the action of the digestive fluids, may cause soft objects to be broken 
up ; the disturbance they produce is then insignificant. 

Of such substances, however, some are quite incapable of digestion 
(clothing, sacks, linen, etc.), and may produce obstructions ; others are 
both indigestible and heavy (gravel and sand), and may fall into the 
depressions of the compartments, where they remain, or, if passed into the 
reticulum, may become arrested in the deepest lying part. They then 
produce atony of the muscular coats, slowing of peristaltic movements, 
diminution in the frequency of eructation, and, as an additional conse- 
quence, chronic tympanites, sometimes visible at the flank. 

The symptoms are vague and common to a number of the digestive 
diseases already described. The animals masticate without having any- 
thing in the mouth ; rumination becomes irregular or is altogether sup- 
pressed, but this is not characteristic, being a symptom common to 
many visceral diseases. 

Later, as a result of auto-infection, diarrhoea sets in ; under the 
influence of abnormal fermentation in the gastric compartments the 
eructations become foetid ; the animals fall into a condition of marasmus. 
Death usually results after a varying time — when large quantities of 
foreign substances have been ingested, in twenty to thirty days. 



200 CHRONIC INFLAMMATION OF THE GASTEIC COMPARTMENTS. 

The diagnosis chiefly rests on the history, and can only be of a 
confident character when one knows what quantity and what kind of 
foreign body has been swallowed. 

The prognosis is grave, because the animal usually dies of pro- 
gressive exhaustion. 

Treatment. There is only one rational form of treatment — viz., 
gastrotomy, followed by examination of the rumen and reticulum and 
removal of the foreign body. Before undertaking operation the surgeon 
should be fully informed as to the cause and the probable results to be 
expected. 

(2.) Foreign bodies with one pointed extremity. These usually con- 
sist of large -headed nails, or fragments of iron w-ire rolled up at one end, 
which have been swallow^ed during primary mastication along wdth 
forage. 

When ingested, they may become implanted at any point in the 
gastric api^aratus without necessarily penetrating deeply. When fixed 
across the division of the reticulum, they cause slowing of its physio- 
logical action. Should they penetrate the wall either of the reticulum 
or of the rumen, they may attack on the right the liver, or on the left 
the diaphragm or spleen, producing suppurating hepatitis, splenitis, or 
respiratory disturbance. The hypochondriac region then appears sensi- 
tive. The muscular portion of the diaphragm is partly paralysed, and 
costal respiration set up, while frequent coughing of reflex origin is pro- 
voked by irritation of the pneumo-gastric and diaphragmatic nerves, and 
may give rise to suspicion of some thoracic disease, from w^iich, how^ever, 
it is distinguished by the absence of discharge, expectoration, and pul- 
monary symptoms. 

Finally, if implanted in the low^er wall or sides of the rumen or 
reticulum, foreign bodies may carry with them infectious agents and 
set up localised or generalised peritonitis. 

Early diagnosis is a matter of great difficulty, as it can only rest on 
the diaphragmatic disturbance or on the symptoms of peritonitis. 

Lesions. Small-sized sharp bodies cause lesions of trifling extent, 
which in most cases are only indicated by retardation of movement of 
the gastric compartments, between which and the diaphragm, and be- 
tween the diaphragm and the posterior portions of the lung, various 
adhesions are set up. In such cases the iDerijDheral inflammation ends 
by producing a fibrous sleeve, which prevents the pleural cavity becoming 
infected. Other cases show patches of adhesive peritonitis or signs of 
generalised peritonitis, the real cause of which often evades discovery 
during life. 

Treatment. Gastrotomy is the sole means of effecting a cure, but we 
are forced to admit that it only gives good results when the operator 



GASTRIC DISTURBANCE DUE TO FOREIGN BODIES. 201 

knows what he is trymg to find. Without this information he acts in the 
dark, is obHged to abandon himself to chance, and although luck some- 
times favours him, it more often leaves him in the lurch. 

(3.) Foreign bodies pointed at both ends. Bodies like needles, pins, 
straight fragments of iron wire, knitting-needles and broken hairpins, 
become im^^lanted in the gastric walls and travel in the most diverse 
directions, in obedience to the varied movements of the organ injured. 
They produce results similar to those just described. Most frequently 
they fall into the lower part of the gastric compartments, pass near the 
ensiform cartilage, between the pleura and the triangularis sterni into 
the thickness of this muscle, or into the mediastinum, and there produce 
either an abscess in the region of the ensiform cartilage, an abscess of 
the thoracic wall, or a collection of pus in the sub -pericardial or sub- 
pleural region (pseudo-pericarditis). They may even reach the peri- 
cardium, causing pericarditis, and sometimes, when adhesions are set up 
between the heart and pericardial sac, carditis. 

By deviating to the right or left, the foreign body may produce 
pleurisy or even j^neumonia. If it moves towards the right, it involves 
the liver and produces suppurative hepatitis ; if to the left, suppurative 
sj)lenitis. Travelling in a downward direction, it encounters the abdo- 
minal wall, and after producing an abscess may be eliminated ; passing 
backwards, it falls into the peritoneum, and may lead to peritonitis. In 
those exceptional cases in which foreign bodies reach the abomasum 
they generally become implanted towards the greater curvature, pro- 
ducing in the abdominal wall an abscess which breaks externally, and 
through which the foreign body is discharged ; gastric fistula is then 
a common sequel. 

The symptoms vary, according to the complications. The earliest 
comprise digestive disturbance, which coincides with the passage of the 
sharp object through the rumen or reticulum, and depends on whether 
such passage produces local peritonitis and pain, rendering movement of 
these compartments impossible. Later, when the diaphragm has been 
penetrated, respiratory disturbance occurs, and is succeeded by apparent 
improvement, which in its turn may be followed by the occurrence of 
pericarditis, pleurisy, or abscess formation. 

In other cases where suppurative hepatitis or splenitis, or even 
peritonitis may be present, the symptoms are extremely vague and very 
difficult to refer to their real cause. 

Diagnosis is difficult, unless the owner is able to supply exact infor- 
mation that at some previous time the animal had swallowed such and 
such an object. 

The prognosis is grave, though cases occur where a foreign body is 
tolerated, and may for a long time be retained without producing accidents* 



202 TUMOURS OF THE GASTRIC COMPARTMENTS. 

Treatment. Gastrotomy should not be performed unless the operator 
is possessed of very precise information. In such case the rumen and 
reticulum should be emptied and the foreign body sought for and removed. 

When the symptoms strongly point to the presence of a foreign body 
exploratory gastrotomy may be performed, but the operator will do well 
to employ the operation only as a last resort. 

Many complications, like septic peritonitis, hepatitis, and splenitis, 
are practically hopeless; but others show a tendency to recovery. This 
is the case when abscesses form in the thoracic or abdominal wall, or 
beneath the pleura or pericardium. The entire difficulty consists in 
diagnosis, for when once this is clearly defined intervention is fully 
justified. As, however, the surgical measures vary in every case, the 
exact course to be adopted must be left to the initiative of the surgeon. 

TUMOUKS OF THE GASTRIC COMPARTMENTS. 

Papillomata result from hypertrophy of normal papillae ; they 
resemble those of the pharynx and oesophagus. The growth may attain 
the size of a fist. It often resembles a cauliflower in appearance. When 
very large, such growths may cause obstruction. A very striking illus- 
tration of a papilloma of the mucous membrane is given on p. 180 of 
Moller and Dollar's " Eegional Surgery." 

Sarcoma has been noted by Paule, Kitt, and Schiitz as forming in 
the subserous tissue of the omasum, and later bulging out as a wounded 
swelling of irregular size. 

Actinomycosis of the abomasum has been reported by Professor 
Axe. 



CHAPTER VI. 
ENTERITIS, 

Enteritis consists in inflammation of the intestine, or, more pre- 
cisely, in inflammation of the intestinal mucous membrane. All the 
constituent portions of the intestinal tube may be affected (duodenum, 
jejeunum, ileum, colon, caecum); but clinical distinctions and localisation 
of inflammation in the various parts are very difficult in the domesticated 
animals, and at present it is impossible to describe with any accuracy 
the differences between duodenitis, enteritis of the jejeunum and ileum, 
colitis or typhlitis. Without doubt certain symptoms suggest that some 
regions are more affected than others ; but clinically we are only able 
to distinguish betw^een acute and chronic enteritis. Acute enteritis may 
assume different forms, according to its intensity, rapidity of development, 
and lesions, so that it is jDOSsible to distinguish between such conditions 
as simple acute enteritis and hsemorrhagic enteritis. 

Chronic enteritis, an abstraction founded on our knowledge of such 
specific forms of enteritis as are due to tuberculosis, distomatosis, 
helminthiasis, etc., usually assumes the diarrhoeic form. 

ACUTE ENTERITIS. 

As acute enteritis, whether localised in one portion of the intestine or 
involving the whole intestinal tube, is produced by varying causes, and 
assumes very varying degrees of intensity, its clinical symptoms are 
equally diverse. 

Causation. The various forms of enteritis result from tw^o great 
series of causes : infections and intoxications. Normally the intestine 
contains an extremely large number of different microbes, which may 
prove of service so long as circulation, secretion, and peristalsis continue 
normal ; but as soon as any perturbation occurs, either in the blood 
supply or in the movement of the bowel, normal secretion is impeded ; 
abnormal organic fermentation commences, producing irritant principles 
or toxins Avhich at once set up local irritation, or, being absorbed, produce 
that complex of symptoms which we recognise as enteritis, intoxication 
of intestinal origin, or even infection. 



204 ENTERITIS. 

Bearing in mind these facts, we are better able to understand the 
part played by cold, by damaged fodder, by intense, stimulating feed- 
ing, or sudden changes in the food, as well as by the action of drastic 
purgatives, which modify beyond physiological limits the condition of 
the glands, or even cause local desquamation of epithelium. 

Toxic substances or plants act similarly by modifying either the 
circulatory, secretory, or motor systems. 

Symptoms. The first appreciable external symptoms appear to result 
from fever — loss of appetite, suspension of rumination, dryness of the 
muzzle and of the mouth, earthy-red colour of the conjunctival mucous 
membrane, etc. 

On manipulating the left flank one notes neither tympanites nor 
sensitiveness — in a word, there is no indication of functional disturb- 
ance of the rumen. 

On the right side, on the contrary, palpation causes the animal to 
resist and to show signs of pain. According as this sensitiveness is more 
marked in the middle or upper region or towards the hypochondriac 
circle, we infer that the inflammation is most acute in the large or 
small intestine, either in the middle portions or, again, in the most 
anterior portion. The temperature always rises at the commence- 
ment, attaining 103° to 104° Fahr. (39*5° or 40° C), but rarely a higher 
point, a fact which negatives the idea of a rapidly progressive infectious 
disease. Slight colic appears, and is accompanied by constipation ; the 
fseces are covered with mucus, or false membranes, or are completely 
enclosed in fibrinous tubes. After four or five days the faeces change 
in character. Constipation gives place to a liquid, blackish, very foetid 
diarrhoea. Finally the mouth exhales a stercoraceous odour, resulting 
from foetid eructation. 

The passage of fiat or tubular false membranes continues for a certain 
time. 

When false membranes constitute the chief symptom, the condi- 
tion is termed '' pseudo-membranous, croupal, or diphtheritic enteritis." 
This form is only a variety of acute enteritis, but is grave, because 
complications due to haemorrhage or infection are very liable to occur. 

In certain cases movement causes groaning. In the slighter forms 
the patient may recover spontaneously. If fed with easily digested 
materials, the symptoms diminish in intensity. Towards the eighth 
day the faeces become normal, appetite and rumination reappear, and 
the secretion of milk which had fallen off rises to its normal amount. 
Kesolution has occurred. 

More frequently, either because the animals have less power of 
resistance or because decomposition is taking place more actively in 
the intestine, or, again, because intoxication is setting in, the disease 



ACUTE ENTERITIS. 205 

becomes aggravated. Constipation is more marked, and the faeces passed 
are in small masses, covered with layers of epithelium, or sometimes 
streaked with blood. In other cases the diarrhoea becomes exaggerated 
and assumes a mucous or sero-mucous character ; the temperature rises, 
and death results from exhaustion and infection, micro-organisms passing 
from the lumen of the intestine through its w^alls and invading the 
general circulation. 

Lesions. To study the lesions to advantage the autopsy must be 
performed as soon as possible after death. 

In slight cases they consist of trifling generalised congestion of the 
intestinal mucous membrane. The points most affected show infiltra- 
tion of the submucous coat, and sometimes of the muscular coat; the 
wall of the intestine is double its normal thickness, but the thickening 
never equals that seen in cases of rapidly fatal intestinal congestion. 

At a more advanced stage the mucous membrane clearly is inflamed, 
its surface is covered with a fibrous exudate, and the glandular and 
epithelial cells proliferate, assume the embryonic form, and produce the 
new tissue which one recognises under the form of false membranes. 

The false membranes are generally but slightly adherent, and are 
readily expelled. 

In other cases, however, they adhere firmly, and when detached by 
the friction caused by movement of semi-digested food through the bowel, 
produce rupture of capillary vessels ; this exjDlains the presence of blood 
streaks in the faeces. 

The diagnosis is relatively easy, especially at the onset, on account 
of the special character of the faeces and the sensitiveness of the right 
flank. 

The prognosis is seldom grave. If the enteritis is taken at the 
beginning, recovery is usual ; but if the animal has been ill for eight 
or ten days and is exhausted, and if fever and diarrhoea are intense, the 
prognosis should be guarded. 

The treatment is that of all acute inflammatory diseases. Mustard 
plasters may be applied to the chest and abdomen 'and left in position 
for some hours, or may be repeated. Some practitioners prefer hot 
blankets or dry friction, or, again, rubbing with essence of turpentine, 
but this substance should be spread over large surfaces, in order to 
prevent injury to the skin. Bleeding is only justifiable in plethoric 
animals, and should never be exhaustive. 

To relieve the digestive symptoms purgatives are at first given, even 
though diarrhoea is marked from the onset ; for purgatives still consti- 
tute the best intestinal antiseptics, because they get rid of the intestinal 
contents and microbes. The diet should be carefully selected, and may 
consist of gruel, mucilaginous materials, linseed tea, cooked roots, etc. 



206 ENTERITIS. 

Of drugs, sulphate of sodium in doses of 10 to 15 ounces is pro- 
bably the best. It can gradually be replaced by 2 to 3 drachm doses of 
bicarbonate of soda or of ordinary salt per day. Laudanum, camphor, 
and bismuth relieve persistent colic and diarrhoea. Pilocarpine, veratrine 
and eserine, though recommended by some authors, present no advantage 
in our opinion. The first two of these substances certainly cause purga- 
tion, but the action is quite temporary. The last induces violent con- 
traction of the striped muscular tissue, and may produce grave lesions or 
invagination when the bowel is diseased, thickened or infiltrated. 

H^MOERHAGIC ENTERITIS. 

This form of enteritis derives its name from the dominant symptom, 
which consists in the passage of unaltered or clotted blood in the faeces. 
In the former case the blood is bright in colour, as if it came directly 
from an open vessel. In the second it is coagulated, and assumes the 
form of fibrinous clots, which seem to result from the superposition, 
in the intestinal tract of their constituent elements, viz., serum, blood 
corpuscles, and fibrin. 

Causation. Hsemorrhagic enteritis is rarely seen except during the 
hottest days of summer, and in young animals which have previously 
shown nothing abnormal. The high temperature seems to favour its 
appearance, but is always supplemented by another cause, viz., the 
ingestion of irritant food, particularly of weeds and toxic plants or 
herbage of bad quality ; amongst such may be mentioned dog's mercury, 
and plants of the order Papaveracese, Euphorbiacese, etc. Otherwise 
the often rapid manner in which the disease develops indicates toxic 
enteritis. 

In other cases, more benign in ajDpearance, but quite as grave in 
reality, blood is passed continually, and the disease assumes a chronic 
form. It is then of parasitic origin, and is due to intestinal psoro- 
spermosis. 

Symptoms. The primary symptoms are similar to those of acute 
enteritis, and consist of fever, dryness of the muzzle and of the mouth, 
colic and constipation. This is soon followed by loose motions con- 
taining blood or blood clots, according as the haemorrhage occurs at a 
greater or less distance from the rectum. The faeces are then ejected 
violently to a considerable distance, on account of the exaggerated 
intestinal peristalsis. 

The disease may produce death in twenty-four hours, though usually 
the end is deferred for several days, or, in cases due to sporozoa, for a 
considerably longer time. In these cases there is some chance of 
recovery, provided that treatment be prompt. 

The diagnosis is very easy. 



HEMORRHAGIC ENTERITIS. 207 

The prognosis is in all cases grave. 

The lesions are ill-recognised. The animals die rapidly, and if not 
immediately examined show no characteristic lesions. The changes to be 
looked for consist in intense congestion or ulceration of the intestine, or 
even in ulceration of arterioles and of arteries of considerable size. 

In parasitic enteritis one finds localised inflammation and, in the 
epithelial interstices, sporozoa, which cause the rupture of blood-vessels. 

Treatment. It is necessary to act energetically from the outset, 
and to arrest haemorrhage by acting on the intestine, on the vascular 
system, and on the skin. Mustard plasters or other external stimulant 
applications are therefore indicated. Internally, small doses of 
astringents like tannin, preparations of opium, 25 per cent, solution 
of sulphuric acid in alcohol, etc., are given to produce constriction of 
the vessels, though they seldom arrest the discharge of blood for long. 
In most cases it is necessary to have recourse to subcutaneous injections 
of ergotine, in doses of 5 to 10 grains in young animals, and 15 to 45 
grains in adults. The dose may be given in two parts to prevent an 
unduly severe action. The smooth fibres of the small vessels are thus 
directly excited, and hsemorrhage ceases in consequence of clotting in 
the contracted vessels. 

One may give for the same purpose injections of arseniate of 
strychnine, which has the advantage of sustaining the tone of the 
heart and preventing syncope. The dose should not exceed 1*5 grains 
in large animals. 

Finally, a stimulating diet containing milk, alcohol, soup, cooked 
vegetables, and small quantities of vegetable pulp is useful. 

With early treatment animals sometimes recover in a few hours. 

Intra-venous or subcutaneous injections of physiological salt solution 
(2 drachms of sodium chloride in one quart of water) may prove of value 
when hEemorrhage has been abundant and vascular pressure is low. 

CHRONIC ENTERITIS (CHRONIC DIARRHCEA). 

Chronic diarrhoea is common in bj'res. It appears suddenly, often 
fails to attract attention, and assumes the form of simple diarrhoea, a 
fact which accounts for it frequently being described as chronic diarrhoea, 
dysentery, etc. 

Causation and pathogeny. This form of diarrhoea occurs sporadi- 
cally throughout France, and under exceptional circumstances may 
permanently attack a number of animals in a given place. 

The immediate cause is not known, but without doubt the disease 
is of microbic origin. Like Lignieres, Moussu at one time believed 
that this disease was very probably identical with that known in 



208 



ENTERITIS. 




-;-x 



Argentina under the names of diarrhoea, enteque, or bovine pasteurellosis. 
The hypothesis has not been verified, and Lignieres' treatment, said by 
him to have succeeded in Argentina, always failed in Moussn's hand. 

The only point which seems admissible is that this disease, which 
Moussu considered to have analogies with chronic sporadic dysentery 
in man, is due to one or several organisms, which develop in the 

intestine and produce toxins, causing 
diarrhoea, without, however, niarked in- 
flammation of the intestinal mucous 
membrane. 

Symptoms. The onset is often over- 
looked. The diarrhoea gradually in- 
creases without appearing to be very 
serious ; but it persists in varying de- 
grees of intensity. The patients do not 
appear to suffer, and do not lose their 
appetite or spirits, but in time the 

f,,., diarrhoea becomes exhausting; they 

\ M w^aste, and after some months become 

# excessively thin and poor. 

Intestinal peristalsis becomes exag- 
gerated without the existence of colic or 
tympanites. The evacuations are fre- 
quent, and little by little the abdomen 
retracts, until, in horseman's parlance, 
"the belly is up to the back," even in 
cow^s of four, seven, and eight years' 
bearing. 

The diarrhoea is serous, always foetid, 
and without tenesmus. 

The faeces may either be very soft 
or be passed in veritable jets. They 
are always a little discoloured, and 
frequently contain grain or undigested 
forage. They ahvays contain numerous bubbles of gas. 

The wasting during later periods of the disease is absolutely 
characteristic, and different from that of other w^asting diseases, such 
as chronic broncho-pneumonia, tuberculosis, etc. The patients finally 
become w^alking skeletons. The red corpuscles of the blood progressively 
decrease, until the number may fall as low as 800,000 or even 500,000 
red corpuscles instead of six millions, the normal figure. The oedema 
common to wasting conditions appears, and the animals die without 
suffering, in a condition of absolute exhaustion. 




Fig. 71. — Appearance of a patient 
suffering from advanced chronic 
diarrhoea. 



CHRONIC ENTERITIS (CHRONIC DIARRHOEA), 



209^ 




Fig. 72. — Appearance of a portion of the small 
intestine in chronic diarrhoea. 



Complications are rare, though ocGasionally intestinal haemorrhage or 
broncho-pneumonia occurs. The temperature, which remains normal or 
shoNYS very slight changes throughout the course of the disease, may then 
oscillate between 101° 
and 103° Fahr. (38° and 
39-5° C). 

Lesions. At the first 
glance no lesions can be 
detected on post-mortem 
examination except those 
of generalised wasting, 
but when the autopsy is 
carried out immediately 
after death all the in- 
terior of the intestine appears affected. The mucous membrane of the 
abomasum and the mucous folds appear infiltrated, thickened, and with 
moderate sub-epithelial congestion. The intestine seems friable, and 
tears with the slightest traction. The sub -epithelial portions of the 

mucous folds are 
infiltrated and con- 
gested, while the 
more prominent 
parts of the folds, 
which are exposed 
to the friction of 
semi-digested food, 
become eroded. 

Throughout the 
length of the jejeu- 
num and ileum the 
mucous membrane 
exhibits multitudes 
of small ulcera- 
tions. 

Histologically, 
the epithelium and 
the glands seem atrophied, without any inflammatory change having 
occurred in the mucous or submucous coats. 

The colon and the csecum show similar lesions, and in addition 
brown deposits of pigment under the mucous membrane and along the 
course of the small blood-vessels. This lesion resembles that found 
in chronic dysentery in man, and suggested to Moussu a possible 
connection between the two diseases. 




Fig. 73. 



-Atheromatous lesions of the aorta in chronic 
diarrhoea. 



D.C. 



210 feNTERltl^. 

The liver is less than the normal size. In the heart Moussu hag 
seen one case of sclerosis of the auricles and calcareous infiltration of 
the sub-endothelial lining of the aorta. 

In several instances he has noted calcareous infiltration of the 
mesenteric lymphatic gland. 

Diagnosis. It is easy to diagnose this condition, and quite possible 
to distinguish it from the diarrhoea of tuberculous enteritis, infectious 
hepatitis, and other conditions. 

Prognosis. The prognosis is very grave, and the disease almost 
always ]3roves fatal. 

Treatment. At the present moment no curative treatment is known. 
Lignieres' treatment— viz., the injection of physiological salt solution 
and serum from healthy oxen, and saline solution or defibrinated blood 
—has never given permanently successful results. 

All the drugs usually employed against diarrhoea, the antiseptics, 
astringents, etc., fail, or confer merely momentary benefit. Econo- 
mically, nothing is to be gained by keeping the patients alive. With 
great care existence may be prolonged for months, or even for several 
years, but the animals never regain condition, and are never of any use. 

The most rapid and lasting good efiects follow the administration of 
2J to 8 fluid drachms of hydrochloric acid per day, given in two portions 
and very freely diluted. 

DYSENTERY IN CALVES. 

This disease sometimes appears on the first day after birth, frequently 
on the second or third. It may be mistaken for septicaemia of umbilical 
origin. 

Symptoms. The young animal may be born vigorous and in good 
condition, though this is exceptional. More frequently it is puny and 
below normal weight. The first evacuation (of meconium) may exhibit 
the diarrhoeic character ; in other cases this peculiarity only appears on 
the second or third day, when half-digested milk is passed. The fluid 
is greyish, extremely foetid, and rapidly becomes brownish and blood- 
stained. Evacuation is frequent and accompanied by tenesmus. 

The patients at once become very dull, refuse to suck, and resist 
efforts to feed them by hand. The temperature rises, and the diarrhoea, 
which at first was of an alimentary character, becomes mucous, serous 
and blood-stained. The little patients appear " tucked up," the flanks 
sink in, the strength diminishes, and in twenty-four hours, or two or 
three days at most, they die of exhaustion. 

Recovery is exceptional, and when the disease assumes this character 
it usually attacks a considerable proportion of the other animals in 
the byre. 



DYSENTERY IN CALVES. 21 1 

Causation. The exact cause of this form of dysentery m new-born 
calves has not yet been identified, but the disease is undoubtedly a microbic 
enteritis, and may even be a primary septicaemia of puerperal origin. 

For a very long time this dysentery was mistaken for simple 
diarrhoea, though it exhibits neither the characteristics, course, nor 
termination of the latter disease. 

The co-existence of epizootic abortion and dysentery in certain byres 
has led some authors to believe that a connection exists between the 
two diseases, and that the young are infected with dysentery at birth. 
Evidently, intra-uterine infection is not exceptional, and it seems quite 
natural that the new-born calf may equally suffer when the fcetal 
envelopes and fluids are infected before parturition. Epizootic abortion 
is probably not the only disease which may produce this condition. 

The diagnosis is very simple. The course of the disease and its 
rapid development prevent it from being mistaken for ordinary diarrhoea. 
It is more difficult to distinguish from septicaemia of umbilical origin, 
although this disease also has well-marked characteristics. 

The prognosis is not hopeful. Statistics show that almost all the 
affected animals die, and that those exceptional cases which survive 
remain puny and sickly. There is no economic advantage in attempting 
to save them. 

The mothers of affected calves seldom show any sign of illness, 
though the after-birth is often retained. 

Lesions. The macroscopic lesions are of very trifling importance 
compared with the gravity of the disease. The digestive tract appears 
congested throughout. The intestinal mucous membrane is moderately 
swollen, but without gross lesions. The intestinal contents exhale a 
sickly, foetid odour. The smaller vessels and capillaries forming the 
peripheral vascular network appear distended, as in septicaemia. The 
carcases putrefy with extreme rapidity. 

Curative treatment is very uncertain. Varying results have been 
obtained with doses of 4 to 5 drams of slight purgatives like boro- 
tartrate of potassium, sodium sulphate, and magnesium sulphate ; 
small doses of intestinal antiseptics like salicylic acid, 15 -grain doses of 
salicylate of soda, 45 to 75 grains of carbolic acid, 2 per cent, carbolic 
solution in doses of 7 to 12 drams ; 1 per cent. Lysol solution in doses 
of 2 to 4 ounces; benzo-naphthol, lactic acid 45 to 75 grains, tar water, 
lime water, etc. Although all these preparations, when carefully used, 
generally give good results in the early stages of simple diarrhoea, 
they appear to fail in dysentery of new-born calves. 

Prophylactic measures are more reliable. They consist : 

(1.) In scrupulous disinfection of the byres when the first case of 
abortion occurs ; 

P 2 



212 ENTERITIS. 

(2.) In successively isolating cows which are about to calve in a 
small speciaJly detached stable ; 

(3.) In carefully disinfecting the genital organs of cows which have 
aborted, firstly with boiled water at a temperature of 100° Fahr., and 
then with 1 per cent, iodine solution. 

Calves which are infected when born cannot be saved, but abortion 
can be prevented and dysentery so stamped out. 

DIARRHCEIC ENTERITIS IN CALVES. 

This disease is usually called " simple sporadic diarrhcea." It may 
appear at any time before weaning, and can usually be cured if treated 
early before the patients show bodily wasting. 

Causation. Indigestion from failure of the abomasum to deal with 
the milk usually precedes diarrhoeic enteritis ; it may terminate without 
complications, but very often is followed by diarrhoea. Anything which 
produces milk indigestion, therefore, favours the occurrence of enteritis. 
Such predisposing influences include over-distension of the abomasum, 
milk of bad chemical composition, milk tainted by keeping or by storage 
in dirty and infected pails, etc. The addition to the milk of nutritive 
substances which the abomasum and intestine are not yet capable of 
digesting, such as wheat, rye, barley, or maize meals, very often produces 
diarrhoea even when the meal is well cooked. 

Chills, privations, irregular feeding, and badly-managed weaning 
may facilitate its development, but none of these causes, however impor- 
tant they may be, seem to play any other part than that of favouring the 
multiplication of the numerous varieties of microbes to be found in the 
intestinal tract. Vascular disturbance occurs, either as a result of direct 
irritation of the intestinal mucous membrane or of the action of toxic 
products contained in milk which has served as a culture medium for 
these microbes ; this is followed by secretory disturbance, and the 
intestinal contents being modified in character, the microbes normally 
present undergo changes in number and quality. Inoffensive organisms 
assume pathogenic qualities and secrete toxic principles, normal digestion 
is disturbed, the intestinal defence becomes less perfect, toxic principles 
which the liver is incapable of destroying are absorbed, and diarrhoeic 
enteritis is set up. 

Symptoms. Diarrhoeic enteritis appears during the second week of 
life, towards the end of the first month, or even later. It is characterised 
by the passage of fseces consisting of mucus and containing little clots 
of milk. 

This is the first stage of alimentary diarrhoea, also termed '' white 
diarrhoea " or " white scour." It may prove unimportant ; it may last a 



DIARRHCEIC ENTERITIS IN CALVES. 213 

day or two and then cease. Most commonly diarrhoea increases and 
assumes a mucous and then a serous character, Avhilst the dejecta exhale 
a very characteristic repulsive smell. The excrement becomes greenish 
brown, and after several days or a week or more may appear blood- 
stained. The number of evacuations varies enormously, depending on 
the gravity of the condition. The ejected material is irritant, and the 
parts soiled by it, like the perineum, hocks, and back of the cannon 
bones, become slightly inflamed as though blistered ; later, the hair 
falls away. 

The general health then begins to suffer. Fever remains moderate, 
but the mouth is pasty, the tongue coated, and the breath foetid. 

The patients become thin, and lose their appetite and spirits. Palpa- 
tion of the abdomen, especially of the right flank, is slightly painful, and 
the pulse is accelerated. 

The diarrhoea may spontaneously diminish if the animal's constitution 
prove sufficiently strong; but if it follows its course, the little patient 
becomes weaker, eats less, the evacuations increase and are accompanied 
by tenesmus. In seven to eight days, in rare cases in four to five, the 
animal dies from toxi-intoxication of intestinal origin, or from infection 
resulting from intestinal germs, particularly the bacterium Coli communis, 
obtaining entrance into the circulation. On the other hand, the diarrhoea 
may continue for Aveeks. 

The diagnosis is easy, and there should be no difficulty in distin- 
guishing this disease from dysentery and from umbilical phlebitis, 
which are also accompanied by diarrhoea. 

The prognosis is grave, unless treatment is early undertaken. In 
the latter case there is a good chance of recovery. 

Lesions. The macroscopic lesions are not of much interest, being 
confined to congestion of the intestinal mucous membrane, superficial 
desquamation of the epithelium, small vascular erosions, and general 
wasting. 

The mesenteric lymphatic glands are swollen and oedematous. 

After death from general infection, it is not uncommon to find pleural, 
peritoneal, and pericardial exudation or even endocarditis. 

Even in cases where no post-mortem change has had time to occur 
cultures from the blood yield varieties of the bacterium Coli communis. 

Treatment. The meals should be given at fixed hours, and regulated 
both as regards quantity and quality. These precautions alone suffice to 
prevent the appearance of diarrhoeic enteritis. 

Curative treatment has every chance of succeeding when under- 
taken at the outset. Delafond and Trasbot recommend mild purgatives, 
which act more rapidly than intestinal antiseptics. These comprise boro- 
tartrate of potash in doses of 4 to 5 drachms, sodium sulphate in doses 



214 ENTERITIS. 

of 2J to 4 drachms, sulphate of magnesia, etc. By evacuating the bowel 
and removing a large number of the germs which have multiplied there, 
they arrest intoxication and prevent infection. Nevertheless, they should 
not be administered for long, and after one or two doses should be fol- 
lowed by antiseptics like benzo-naphthol, in doses of 15 to 30 grains, sali- 
cylic acid in doses of 5 to 10 grains, or salicylate of soda 45 to 60 grains. 
Mucilaginous and sweetened drinks containing lactic acid in doses of 45 
to 75 grains per day may be given between the meals, or at intervals if 
the calf is sucking. 

Laudanum in doses of 6 to 10 drops per day administered in rice 
water, extract of opium, weak solutions of tannin, etc., are also of value. 
Filliatre has successfully used tar water in the first stages. The solution 
consists of vegetable tar 6 drachms, boiling water 1 quart. This solution 
is used tepid in the proportion of 1 part to 3 parts of warm milk. 

Decoctions of spiked purple loosestrife, willow bark, etc., are also of 
great value in certain districts. 

The drug which appears least dangerous, however, is that so often 
successfully used in young children — viz., subnitrate of bismuth. It 
can be given in doses of 30 to 45 grains per day, with lactic acid in doses 
of 75 to 150 grains, according to the size of the patients. If the animals 
are greatly exhausted and have been ill for some time there is less chance 
of recovery, and under these circumstances Dr. Lesage's anti-colic serum 
might be used. 

It gives excellent results in infants, and it has proved successful in 
simple diarrhoea of calves. 



CHAPTER VII. 
POISONING, 

x\cciDENTAL poisoiiiiig is frequGiit in domesticated animals. It may 
present no visible lesions, and it is therefore very important to recognise 
the symptoms which indicate the secret lesion. 

POISONING DUE TO FOOD, 

Under this title are included all forms of poisoning resulting from the 
ingestion of bad fodder. Such expressions as "intestinal typhus" and 
" typhic gastro-enteritis " only indicate a special stage in the condition, 
which is never twice the same. 

Causation. The most important changes in the food ingested do not 
consist in a mere modification in its chemical composition, but in the 
presence of various parasites which develop in grain and forage, after 
moistening, or after abnormal fermentation in the interior of the grains. 
These parasites are chiefly represented by fungi belonging to the genus 
Mucor : Asperciilhis or Penicillium ; blight — Puccinia graminis, Uredo 
linearis ; smut — Tilletia caries, Ustilago segetum, Ustilago maydis ; 
yeasts of different kinds resulting from the fermentation of brewers' 
grains ; and, finally, unrecognised microbes which act by means of the 
poisons they secrete. 

The symptoms are always very vague. At first the only marked 
symptom is loss of appetite, accompanied by dryness of the mouth and 
muzzle, depression and constipation. The animals never clearly show 
signs of gastro-enteritis ; nevertheless, the changes in general health 
point very clearly to a digestive origin. 

In cases of acute poisoning the symptoms develop rapidly. Torpor 
becomes more marked, the movements of the heart tumultuous, and the 
temperature rises to 105° Fahr. (40'5° C), diminishing later until death 
occurs. 

In chronic forms of poisoning constipation is present at first, but is 
soon followed by profuse, foetid, blackish diarrhoea, sometimes containing 
streaks of blood and accompanied by abdominal pain. 

In exceptional cases these digestive symptoms are amplified by the 
presence of broncho -pneumonia, pleuro -pneumonia, nephritis, and cystitis, 



216 POISONING. 

as in poisoning by tannin and essential oils. These complications are 
of infectious origin. 

In young animals, like lambs and young pigs, still with their mothers 
alimentary intoxication may also occur though the mothers show no 
signs of illness. The passage of poisonous principles into the milk 
cannot be disputed. Moussu has seen numerous cases of alimentary 
intoxication in lambs whose dams were fed with decomposed beet pulp, 
and in sucking pigs whose mothers had received bad maize, turnips, etc. 

Diagnosis. Careful examination of the substances with which the 
animals are fed, and consideration of the history, prevent confusion with 
ordinary poisoning. Anthrax as a cause can easily be eliminated. 

The prognosis is grave, unless the practitioner is summoned early. 

The lesions are those of acute gastro-enteritis— congestion of the 
mucous membrane, abomasum, and intestine, submucous infiltration, 
shedding of the epithelium, which sometimes attains the stage of ulcera- 
tion, suffusion and intestinal or superficial haemorrhage, dilatation of the 
capillaries, etc. 

The symptoms of poisoning are produced by the absorption of toxic 
products, which pass from the intestine into the blood current. 

Poisoning is frequently complicated by infection produced in a similar 
manner. 

Treatment. The first point is to change the food. This alone is 
often sufficient to dispose of the digestive disturbance in a week or two. 
In addition, mustard plasters may be applied, and purgatives, stimulants 
and mucilaginous drinks may be given. Finally, diuretics are useful in 
eliminating the toxic products accumulated in the blood. They comprise 
general stimulants like wine, alcohol, tea, coffee, etc. Subcutaneous or 
intravenous injection of physiological salt solution is indicated. 

POISONING BY CAUSTIC ALKALIES. 

The cause consists in the administration of insufficiently diluted 
solutions of ammonia in cases of tympanites, or the ingestion of quick- 
lime, used for disinfecting stables, by animals suffering from depraved 
appetite. 

The symptoms indicate injury to the anterior part of the digestive 
tract. They consist in salivation, loss of appetite, colic, indigestion, 
diarrhoea, and progressive loss of strength. 

Diagnosis is only possible when the history is clear. 

The prognosis is grave if the doses swallowed have been so large 
as to cause severe burning of the mouth, oesophagus, rumen, etc. The 
local lesions are grey and soft. 

Treatment consists in immediately giving acidulated draughts con- 
taining vinegar or 1, 2 or 3 per cent, of hydrochloric acid, and emollient, 



POISONING BY THE NITRATES OF POTASH AND SODA. 217 

mucilaginous drinks containing opium for the purpose of calming the 
irritation. 

POISONING BY CAUSTIC ACIDS. 

Cases of this kind are rare. Gerlach described a case of poisoning by 
straw which had been removed from sulphuric acid carboys. Abadie 
saw a number of cases which were traced to the unskilful treatment of 
two empirics. 

The symptoms point to the existence of stomatitis, oesophagitis, and 
gastro-enteritis. Death occurs rapidly, with a running-down pulse. On 
post-mortem examination one discovers more or less deep burning of the 
mucous membrane of the digestive tract. 

The diagnosis is difficult in the absence of information. 

The prognosis is grave. 

Treatment comprises administration of alkaline draughts, solutions 
of bicarbonate of soda, calcined magnesia, etc., and of mucilaginous drinks 
containing opium, chalk, etc. This may produce temporary relief. 

Water mixed with whipped whites of eggs is also extremely valuable, 
but it is often better to slaughter the animal as soon as the condition is 
diagnosed. 

POISONING BY COMMON SALT. 

This form of poisoning is rare in oxen on account of the large 
quantity of salt which can be ingested without producing bad effects. 
It is commonest in animals to which old brine has been given or which 
have received rough salt containing toxic substances (sheep and pigs). 
Beef, pork, or fish brine, four or five months old, is especially dangerous 
because of the toxins it contains. Half a pint is a fatal dose for a pig 
(Reynal). The symptoms include marked thirst, vomiting and diarrhoea ; 
at a later stage motor and nervous disturbance appears, resulting from 
poisoning of the cerebro-spinal system. Paralysis, epileptiform convul- 
sions, trismus, coma and death characterise extremely acute cases. 

To the naked eye, the lesions are those of acute gastro-enteritis ; 
and, in many cases, of marked congestion of the brain and medulla and 
of the mucous membrane of the bladder. 

The treatment is prophylactic and hygienic. Old brine and salt of 
doubtful purity should be avoided. The symptoms should be treated by 
administering diuretics, preferably soda bicarbonate, which does not 
irritate the kidney, and by giving mucilaginous drinks with anodynes. 

POISONING BY THE NITRATES OF POTASH AND SODA. 

This form of poisoning has frequently been described as following the 
ingestion of water used for washing sacks which have contained chemical 



218 POISONING. 

manures. Occasionally it results from the administration of medicines 
containing excessive doses of nitrate of potash. The symptoms vary in 
severity with the purity of the salt, with its nature, and with the degree 
of concentration of the solution : nitrate of potash is more dangerous 
than nitrate of soda. 

The chief symptoms may be grouped as follows : — 

Salivation, indigestion and tympanites, nausea, vomiting, diarrhoea, 
and (especially) intense polyuria : the kidney may be irritated to such a 
degree as to produce albuminuria and hgematuria. Intense dulness 
and general weakness precede death, which sometimes occurs in four to 
twelve hours after the poison has been taken. 

The lesions are to be found in the digestive and urinary apparatus. 
The kidneys are congested and hypertrophied, or present changes indi- 
cating epithelial nephritis. The ureters and the bladder may show 
similar lesions. 

Treatment comprises removal of the cause, and the administration 
of emollients, narcotics, and diffusible stimulants. 

POISONING BY TARTAR EMETIC. 

Tartar emetic is sometimes given for the purpose of favouring secretion 
and restoring rumination ; occasionally the proper dose is exceeded and 
poisoning occurs. Given repeatedly, tartar emetic is apt to accumulate 
in the deeper portions of the gastric compartments and to produce 
general symptoms of super-purgation, and such local symptoms as 
ulceration and even perforation of the walls of the stomach, which in 
turn is followed by abscess formation in the abdominal Avail. 

Diagnosis is easy. The prognosis is grave. 

Treatment is confined to the administration of mucilaginous and 
diuretic fluids. Tannin has been recommended. 

POISONING BY ARSENIC. 

Overdoses of Fowler's solution produce rapidly fatal results, in 
twenty-four to forty- eight hours. Lesions are little marked. 

Arsenious acid acts like tartar emetic by accumulating and producing 
local gastritis; it may also cause acute poisoning, being in that case 
characterised by severe colic with tympanites, salivation, and foetid, some- 
times blood-stained, diarrhoea. The urine becomes albuminous, and re- 
mains scanty. Incomplete paralysis is sometimes produced, and various 
forms of haemorrhage result from changes in the constituents of the blood. 

If the gastric compartments are perforated, an abscess may develop 
in the abdominal wall. The lesions are those of acute gastro-enteritis. 
The contents of the stomach exhales an odour resembling garlic. The 



MERCURIAL POISONING. 219 

parenchymatous organs — the Hver, kidney, and heart — show fatty de- 
generation in chronic cases. 

In prescribing arsenic, one should begin with small doses, which can 
gradually be increased as the animal becomes accustomed to the drug. 
Curative treatment consists in administering antidotes, such as hydrated 
oxide of iron, sulphate of iron, and calcined magnesia. 

Haubner described a form of chronic arsenical poisoning produced 
in the neighbourhood of blast furnaces near Freiberg. Similar forms 
of poisoning may perhaps occur in the neighbourhood of chemical and 
smelting works in England. 

PHOSPHORUS POISONING. 

Though the chronic form is common in men, jDhosphorus poisoning 
only occurs accidentally in animals through eating phosphorus paste, 
used as a poison for rats, or as a consequence of excessive doses given 
medicinally. Some cases have been described by Maury. 

The symptoms comprise salivation, loss of appetite, alliaceous 
odour of the buccal cavity, arrest of intestinal peristalsis, indigestion, 
colic, diarrhoea, exhaustion and death in a state of coma. Albumi- 
nuria and icterus also occur. 

The lesions are the same as those of arsenical poisoning — viz., 
stomatitis, pharyngitis, and gastro-enteritis. The specific changes con- 
sist in fatty degeneration of the liver and kidneys, and the peculiar 
odour resembling garlic exhaled hj the flesh. 

Death is a consequence of deoxygenation of the blood, which appears 
black, and when spectroscopically examined reveals only the lines of 
reduced haemoglobin. 

Treatment. Oil and milk dissolve phosphorus and render it more 
easily assimilable ; they should never be administered. Large doses (up 
to six fluid ounces) of essence of turpentine have been recommended. 
This prevents the phosphorus absorbing oxygen at the expense of the 
blood. Saline purgatives assist in eliminating the poison, 

IMERCURIAL POISONING, 

Mercurial poisoning may result either from the administration of 
medicines or from accident. Cases of the former kind follow the internal 
use of sublimate or calomel. Doses of 2 to 2 J drams of calomel, if 
repeated for a certain time, may prove toxic in the ox. Accidental 
poisoning results from the use of mercurial ointment as a parasiticide 
over large surfaces. Poisoning, however, rarely occurs unless the animal 
is able to lick the parts. Some authors have tested this point by freely 
applying mercurial ointment over parts likely to absorb it readily, with- 
out having seen any badeffect. 



220 POISONING. 

Symptoms. Free salivation, the saliva gradually becoming foetid 
and blood-stained. The slight irritation of the buccal membrane first 
seen is soon replaced by congestion of the gums, then by gingivitis and 
periostitis, with local ulceration and haemorrhage. The portion of the 
gums surrounding the teeth becomes violet, and suppurative alveolitis 
may follow. 

As a consequence of disturbance in the digestive secretions digestion 
ceases, defaecation becomes irregular, the faeces are often hard and coated, 
and can only be passed with difficulty, though sometimes there is profuse 
foetid diarrhoea. 

Kespiration is difficult, jerky, or even dyspnoeic, and is accompanied 
by discharge from the nose and by expectoration. The gait is irregular, 
and paralysis may follow. Finally the skin shows an eruption resembling 
that of impetiginous eczema ; vesico -pustules, covered with yellowish 
crusts, appear over the entire surface of the body. 

Lesions. The lesions of haemorrhagic gastro- enteritis are sometimes 
accompanied by catarrhal tracheo-bronchitis, and even intra-pulmonary 
haemorrhage. The muscles are discoloured, appear as though boiled, and 
are covered with ecchymoses. Blood effusions occur beneath the ecze- 
matous crusts, but the rest of the skin is anaemic. 

Treatment includes administration of raw eggs, or, better still, of 
white of egg beaten up in water ; the albumen in coagulating imprisons 
the mercury. Failing these, other bodies, like flowers of sulphur and 
iodide of potassium, which with mercurial salts form soluble and 
harmless compounds, may be given. Chlorate of potash has also been 
recommended. 

Complications like stomatitis and gastro-enteritis are treated by the 
usual methods. 

LEAD POISONING : SATURNISM. 

Lead poisoning is very rare, and seldom occurs except near camps or 
factories. It then results from swallowing lead '' spray" mixed with the 
grass or from inhalation of lead vapour. 

The symptoms comprise salivation, nausea, colic, obstinate consti- 
pation, tympanites, and arrest of milk secretion. A peculiar form of 
trembling affects the head; epileptiform convulsions, amaurosis, and 
paralysis may also occur. General sensibility diminishes, and death 
follows. 

The disease may assume a chronic form, characterised by a blue line 
around the gums, changes in the joints, albuminuria, and bodily wasting. 

The lesions are those of ulcerative stomatitis, anaemia of the mucous 
membranes, and fatty degeneration of the epithelium. In the chronic 
form the kidneys are atrophied. 



POISONING BY ALOES. . 221 

Treatment consists in giving substances ^yhicll form insoluble com- 
pounds ^Yith lead. It comprises the administration of dilute sulphuric 
acid, solutions of sodium sulphate or magnesia, milk, eggs, and iodide of 
potassium. 

COPPER POISONING. 

This is a rare form of poisoning. It may follow ingestion of food 
stored in co^Dper vessels, licking of ointments containing copper salts, or 
ingestion of vine leaves, or leaves of other plants which have been sprayed 
with sulphate or acetate of copper to prevent " mildew." 

The symptoms comprise vomiting of green-coloured material, colic, 
diarrhoea, muscular weakness, and convulsions. The urine contains dis- 
solved albumen and haemoglobin. 

The lesions are those of acute enteritis and dilatation of the 
stomach. The essential lesion consists in decomposition of the blood 
with the formation of methaemogiobin. Nephritis and granular degene- 
ration of the muscles form secondary symptoms. 

Treatment consists in administering raw eggs, albumen, milk, muci- 
lage, flowers of sulphur, or calcined magnesia. 

CARBOLIC ACID POISONING. 

Carbolic acid poisoning sometimes follows the use of carbolic acid 
solutions in the form of injections, enemas, or baths. 

Symptoms. Administered in over-doses or for too long a time, car- 
bolic acid produces stomatitis, oesophagitis and vomiting. 

True poisoning is characterised by changes in the kidneys and bladder ; 
the urine becomes brown and turbid, and possesses a well-marked carbolic 
odour, the animals suffer from severe trembling and appear stupid, and 
coma and paralysis precede death. 

The specific lesions consist in parenchymatous nephritis, sometimes 
accompanied by renal haemorrhage, cystitis and hyperemia of the lung 
and brain. The flesh has an odour of carbolic acid, which renders it unfit 
for human consumption. 

Treatment consists in giving stimulants and slight diuretics, such 
as ether, alcohol, wine, coffee, saline sulphates, or Glauber's salt. The 
last named forms phenyl- sulphuric acid, which is not toxic. Olive, 
rape, or linseed oil has been recommended. All these drugs are useless 
if the kidney lesions have become too pronounced. 

POISONING BY ALOES. 

This form of poisoning is caused by administering over-doses of aloes. 

Apart from the accidents possible in pregnant female animals, large 
doses of aloes produce symptoms of super-purgation — profuse diarrhoea, 
running down pulse, and nervous prostration. 



222 POISONING. 

» 

The lesions are those of gastro-enteritis, the mtestme being empty, 
and its mucous membrane of red colour. 

Treatment is confined to administering drugs Hke camphor, rice, 
bismuth, opium, chloral, and emollients, which diminish peristalsis and 
lessen secretion. 

IODOFORM POISONING. 

The causes are limited to the licking of wounds which have been 
dressed with iodoform. 

The symptoms include gastric disturbance, somnolence, coma, and 
the signs of iodism. 

The only lesions are those of fatty degeneration of the kidneys and 
liver. 

Treatment comprises the exhibition of vomitants, stimulants, and 
diuretics. 

IODINE POISONING : IODISM. 

Death by iodine poisoning is absolutely exceptional : the complications 
described under the name of iodism are rather to be referred to satura- 
tion of the organism than to true poisoning. 

The cause of iodism is unduly prolonged administration of iodide of 
potassium, or of iodine in solution. 

The symptoms include discharge from the eyes, coryza, hypersecre- 
tion from all the mucous membranes, and gastric disturbance. The 
cutaneous eruption exhibits special peculiarities, including desquamation 
of the epidermis in the form of bran-like scales, and pruritus. 

The first indications in treatment are to discontinue the drug and to 
administer stimulants and nutrients like milk, cod-liver oil, etc. 

STRYCHNINE POISONING. 

Strychnine poisoning is most commonly due to over-doses of the drug 
accidentally given during treatment. 

The symptoms comprise tetanic convulsions, hyperesthesia and 
dys]3noea. As a result of muscular rigidity, the ribs cannot be moved, 
and death by asphyxia follows. 

Treatment comprises the use of anaesthetics, and the administration 
of chloral hydrate, as long as the contractions continue. Bromide of 
potassium, tobacco, tannin, etc., are also useful. 



The chief part of the botanical descriptions in the following list have 
been extracted, by permission, from the Annual Eeport for 1898 of the 
United States Bureau of Animal Industry, p. 392. To Dr. D. E. Salmon, 



I>LANTS POISONOUS TO STOCK. 223 

who gave this permission, and ^Yho also kindly supplied the blocks, the 
writer (Mr. Dollar) desires to express his very sincere thanks. Consider- 
able modifications have been made, and in the case of the more important 
poisonous plants, details of symptoms and treatment have been added. 

LIST OF PLANTS POISONOUS TO STOCK.* 

PERISPORACE^ (rot-mould FAMILY). 

Aspergillus glaucus. — This is the common flocculent woolly mould 
which sometimes develops to a dangerous extent on corn, oats, and other 
food grains w^hich have either been harvested before full maturity or been 
stored in a damp place. The mouldy growth is pure white at first, but 
changes with the ripening of the spores to gray and then green. The 
spores are apparently the cause of the so-called enzootic cerebritis, or 
" staggers," of horses, which, during the winter of 1898-99, was reported 
as having caused very heavy losses in the southern portion of the United 
States. European investigators have shown that the spores of this mould 
will grow Avithin the living body if they are introduced into the blood. 
Death is probably caused by some poison which is simultaneously produced 
with the mould in the body of the animal. 

HYPOCREACE^ (eRGOT FAMILY). 

*ClaYiceps purpurea. — This, the most common species of ergot, 
infests various species of native and cultivated grasses. It sometimes 
causes great losses of stock. 

POISONING BY ERGOT OF RYE : ERGOTISM. 

Causation. This form of poisoning is due to the presence of ergot in 
grain or forage. 

Symptoms. The symptoms are seldom very marked. In mild cases 
]3regnant females may abort ; grave cases are indicated by local gangrene 
of the mucous membrane and gangrene of the extremities, particularly 
in poultry, in consequence of the constrictive action of the drug on the 
peripheral blood-vessels, on the vaso-motor centres, and on unstriated 
muscular fibres. 

Treatment. The use of chloral and morphine has been suggested in 
this condition ; but as the lesions when discovered are established and 
permanent, this treatment seems illusory. More is to be expected from 
preventive measures and the avoidance of ergotised food. 

* The names of plants proved beyond doubt to be poisonous to stock are marked 
with an asterisk. The evidence in regard to the toxic properties of others is not in 
every case entirely convincing, though there is good ground for strong suspicion. 



224 



POISONING. 



USTILAGINACE^ (SMUT FAMILY). 

Ustilago maydis. — The black powdery fungus known as corn smut is 
common throughout the corn-producmg districts of the central United 
States, and is occasionally reported as being fatal to stock. Experiments 
made in Wisconsin and elsewhere show that it is not a very active poison 
when eaten in moderate quantity. When given in gradually increasing 
amounts up to 2 lbs., no effect was noted, but 4 lbs. on each of two 
successive days caused the sudden death of one cow. Since corn smut 




Fig. 74. — Fly amanita {Amanita muscaria). a, Mature plant ; b, top view of cap 
showing corky patches — both one-half natural size. 

has been shown to be less fatal when wet, it seems probable that its 
physical and not its chemical character may be responsible for the death 
of cattle which have eaten it in considerable quantity. 



POISONING BY SMUT OF BARLEY. 



Causes. The presence of smut in straw, in millers' grains, or in 
damaged kiln-dried grains which have fraudulently been added to grain 



PLANTS POISONOUS TO STOCK. 225 

sold for feeding, represents the principal source of this form of 
poisoning. 

The symptoms are very vague. There is indigestion, with a ten- 
dency to nausea, and vomiting. Diarrhoea may be present : At a later 
stage the heart and nervoas system are affected. The gait becomes hesi- 
tating, the animals show general dulness and spasm of the pharynx ; 
death, when occurring, is by cardiac or respiratory syncope. 

Treatment consists in giving an entire change of food, and adminis- 
tering stimulants and purgatives. 

AGARICACE^ (MUSHROOM FAMILY). 

Amanita muscaria.— The well-known fly amanita (fly fungus ; deadly 
amanita) may be found from spring to early winter in pine forests 
throughout the United States. Cows are supposed to be killed by eating 
it, and almost every year the daily papers chronicle the death of several 
human beings who were led to eat the fungus through mistake for some 
edible species. The fresh cap is frequently rubbed up with milk and 
used to poison flies. 

PHALLACE^ (stink-horn FAMILY). 

*Clathrus columnatus. — In an article published in the Botanical 
Gazette (Vol. XV. p. 45), Dr. Farlow, of Harvard University, gives an 
account of an investigation of a case of poisoning in hogs which was 
caused by eating this peculiar fungus. It grows in patches in oak woods 
and openings, and is quite common throughout the Southern States, 

POLYPODIACE^ (fern FAMILY). 

Pteris aquilina. — In July, 1895, nineteen cattle died in Maryland, 
which were supposed to have been poisoned by eating the common 
bracken fern. Very few similar cases are on record, but one European 
authority cites one in which five horses were killed by eating hay con- 
taminated with this fern, and another states that cases are quite frequent 
among cattle in England. 

EQUISETACE.E (hORSETAIL FAMILY). 

Equisetum aryense. — The field horsetail was reported from Con- 
necticut in 1871 as being poisonous to horses. Cases are very rare, and 
it is probable that this plant is deleterious only when eaten in consider- 
able quantity, and then perhaps only on account of its physical character. 
Experiments made in Europe show that a similar species {E. jxilustre) is 
fatal to horses when fed in considerable quantity with hay. 

D.C. Q 



226 POISONING. 

TAXACE^ (yew family). 

Taxus minor. — The common yew, or ground hemlock, is called poison 
hemlock in some places. The leaves of this shruh are probably poisonous 
to stock, as are those of the European yew. This species is more acces- 
sible to stock than the western yew {Taxus hrevifolia), which grows only 
in deep canons. 

YEW POISONING (tAXUS BACCATA). 

The leaves of yew, when eaten in any considerable quantity, are very 
poisonous. Two ounces to eight ounces, according to the size of the 
animal, slow the heart's action, produce weakness, staggering, and 
apoplectic congestion, which may have a fatal result in less than an 
houi'. The bark is less injurious, and the fruit is scarcely poisonous 
at all. 

The early symptoms, which are only seen in chronic cases, consist 
in excitement, followed by somnolence and muscular weakness, with 
slowing of the respiration and circulation. 

POACE^ (grass family). 

Lolium temulentum. — The seed of the darnel, or poison rye grass, an 
introduced annual especially abundant on the Pacific Slope, is considered 
poisonous to both man and animals. 

Stipa robusta. — This is a perennial plant which is known in Arizona 
and New Mexico as sleepy grass. It produces a narcotic effect on horses 
and cattle that feed upon it, but stock bred in that region rarely touch it. 

Zea mays. — The numerous deaths that are frequently attributed to 
Indian corn are mostly due, not to any poison inherent in the plant, but 
rather to parasitic or saprophytic fungus growths, as noted under Asper- 
gillus and Ustilago. The green fodder is very apt to cause severe and even 
fatal tympanites if the animal's diet is not properly regulated. Death 
has also been attributed to the presence of nitre (potassium nitrate) in 
the growing stalks. It is supposed that in very rich soil this substance 
will sometimes accumulate in the stalks in considerable quantity during 
prolonged drought. 

poisoning by the male tufts of maize. 

The green tufts alone are toxic ; the toxicity disappears after drying. 
Prolonged administration produces nephritic colic and renal lithiasis. 

POISONING BY SWEET SORGHUM GRASS. 

This form of poisoning is characterised by attacks of trembling, 
tympanites, and frequent attempts to urinate. The heart beats feebly. 



PLANTS POISONOUS TO STOCK. 



227 



and the pulse grows progressively weaker, until at last it becomes 
imj^erceptible. 

MELANTHACE^ (bUNCH-FLOWER FIMILY). 

*Chrosperma muscsetoxicum. — The bulbous portion of the fly poison, 
or crow poison, an eastern plant, is sometimes eaten by cattle with fatal 




Fig. 75. — False hellebore {Veratrum 
viride), one-third natural size. 




Fig. 76.— Lily of the valley {Con- 
vallaria majalis), one-third 
natural size. 



results. The bulbs, when crushed with molasses, are used to stupefy 
flies. 

*Yeratrum viride. — The leaves of the common swamp hellebore 
(American white hellebore ; false hellebore ; Indian poke) of the eastern 
and northern portions of the United States have proved fatal to man and 
to horses. Sheep eat the young leaves and shoots with apparent reUsh. 
The seed is poisonous to chickens. 

Zygadenus venenosus. — The name death camas has been applied 
to this plant in the North- West of America to distinguish it from the 
true camas (Qiiamasia qnamash), which is highly esteemed for food by 

Q 2 



228 POISONING. 

the Indians. In Oregon it is erroneously called " lobelia " by most 
stockmen and farmers. Horses, cattle, and sheep, as well as man, 
are poisoned by eating the bulb. 

Zygadenus elegans. — The bulbs, and perhaps the leaves, of the 
Glaucous zijgademis, or alkah grass, are poisonous to cattle. 

CONVALLARIACE.E (lILY OF THE VALLEY FAMILY). 

Convallaria majalis. — All parts of the lily of the valley are power- 
fully poisonous, and are liable to injure cattle and horses. 



H/EMODORACE^ (bLOODWORT FAMILY). 

Gyrotheca capitata. — This is the red root, or paint root, of the 
Atlantic coast and Cuba, so called on account of the red colour of its 
sap. White hogs are supposed, throughout the Southern United States, 
to be particularly subject to the poison contained in the plant. 



FAGACE^ (beech FAMILY). 

Quercus sp. — In Europe the acorns of various species of oak cause 
sickness and death in hogs and cattle. This effect may possibly be due 
to tympanites, but may also be due in some way to the tannin or the 
bitter principle which they contain. 

POISONING BY ACORNS. 

The acorn, or fruit of the oak {Quercus rohur and Quercus sessili- 
flora), is much valued as a food for swine. "A peck of acorns a day 
with a little bran will make a hog, 'tis said, increase a pound weight 
2)er diem for two months together." Though largely consumed by swine 
with no apparent ill effects, acorns constitute a dangerous food for young 
cattle, especially when eaten before they are ripe and when herbage or 
other feeding is scanty or restricted. 

The symptoms comprise dulness, loss of appetite, constipation, 
followed by diarrhoea, with straining and colicky pains, head carried 
low, eyes retracted, with mucus about the eyelids and blood-stained 
discharge from the nose. Frequently the abdomen is distended. 
Temperature normal. 

The lesions are, abrasions of the buccal membrane on the palate, 
cheeks, etc. ; impaction and intense congestion of the omasum. 

Treatment. Change of pasture. Alkalies — potash or soda bicar 
bonate, magnesia ; tonics and stimulants. 



PLANTS POISONOUS TO STOCK. 



229 



URTICACE.E (nettle FAMILY). 

* Urtica gracilis. — The slender nettle covers thousands of acres of 
reclamied swamp land in IMichigan and Wisconsin, ^Yhich is made nearly 
^yo^thless by its dense growth, horses refusing to pass through it to culti- 
vate the soil. 

CHENOPODIACE^ (gOOSEFOOT FAMILY). 

Sarcobatus vermiculatus. — Black greasewood, or chico, is a scraggy 
shrub which grows in strongly 
alkaline soil in the south-western 
and w^estern portions of the United 
States. A correspondent in New 
Mexico states that on one occasion 
he counted as many as 1,000 sheep 
that had been killed by eating the 
leaves of this plant. It is claimed 
that cows are not affected by eating 
it at any time, and that sheep can 
eat it quite freely in winter. Death 
is perhaps due more to tympanites 
rather than to any poisonous sub- 
stance which the plant contains. 

PHYTOLACCACE^ (POKEWEED FAMILY). 

* Phytolacca decandra. — The 
leaves of the common pokeweed 
(poke ; garget ; American night- 
shade) of the eastern half of the 
United States is occasionally eaten 
by cattle with fatal results. 

ALSINACE^ (pink FAMILY). 

* Agrostemma githagO. — The ^^^- 77.— Slender nettle {Urtica gracilis). 
common corn cockle (cockle; mul- 
lein pink) is a weed common to both the United States and Europe. 
Poultry and household animals are occasionally poisoned by eating the 
seeds or the bread made from wheat contaminated with the seeds. 




MAGNOLIACE^ (MAGNOLIA FAMILY). 

Illicium floridanum.' — The leaves of this species of anisetree are 
supposed to be poisonous to stock. 



230 



POISONING. 



RANUNCULACE.E (CROWFOOT FAMILY). 

* Aconitum napellus. — Aconite (monkshood; wolfsbane) is very com- 
monly cultivated in gai'dens, and is therefore capable of doing great 
damage to stock. Horses and cattle have frequently been poisoned by 
eating the leaves and flowering tops. 

* Aconitum columbianum. — The Western aconite, or monkshood, is 
native in the north-western portion of America, where it sometimes 
poisons sheep. 

Anemone quinquefolia. — The common wind flower, which grows 
throughout most of the United States, is extremely acrid and poisonous. 
Cattle seldom touch it. The plant loses most of its poison in drying. 




Fig. 78. — Poke weed {Phytolacca decandra), one-half natural size. 



* Delphinium tricorne. — The dwarf larkspur, or stagger weed, of the 
north-eastern quarter of the United States has been especially reported 
from Ohio as fatal to cattle in April, when the fresh leaves appear. 

* Delphinium consolida.— The seeds of the commonly introduced 
field larkspur are well known to be poisonous; the leaves are known 
in Europe to be fatal to cattle. 

* Delphinium menziesil.— The purple larkspur of the north-western 
quarter of the United States is very common throughout Montana. In 
one case of poisoning reported by Dr. E. Y. Wilcox, of the Montana 
Experiment Station, over 600 sheep were affected, 250 of which were 
claimed to have been killed by the weed. An experiment made by 



PLANTS POISONOUS TO STOCK. 



231 



Dr. S. B. Nelson, Professor of Yeterinary Sciences in the Washington 
State Agricultural College, shows that it is possible to feed as much as 
24f lbs. of the fresh leaves to a sheep within a period of five days 
without any apparent ill effect taking place. An experiment made by 
Dr. Wilcox shows that the extract from less than an ounce of the dried 




Ftg. 79. — Corn cockle [Agrostemma git- 
hag o). a, Sprays showing flowers and 
seed capsule, one-third natural size ; 
6, seed, natural size ; 6, seed, four 
times natural size. 




Fig. 80. — Aconite {Aconitum columhia- 
num). a, Flowering plant ; h, seed cap- 
sule — both one-tliird natural size. 



leaves killed a yearling lamb in tw^o hours, the dose having been given by 
way of the mouth. 

LARKSPUR POISONING IN SHEEP.* 

Severe losses have from time to time been recorded, especially in 
America, from larkspur poisoning, the number of animals lost amounting 

* The following account is summarised from a bulletin of the Montana Experiment 
Station by Dr. Wilcox. 



232 POISONING. 

to thousands. The first signs of poisonmg are slight general stiffness 
and straddling gait, especially of the hind legs. The stiffness becomes 
more and more pronomiced, until walking is difficult and evidently painful. 
Soon there are manifested various involuntary twitchings of the muscles 
of the legs and sides of the body, and loss of control or co-ordination of 
the muscles. Ordinarily there is no increase in the quantity of the saliva, 
no dribbling of saliva from the mouth, no champing of the jaws or at- 
tempts at swallowing. The sheep manifest none of the mental disturb- 
ances frequently seen in cases of poisoning from other sources, as for 
example loco-weed and lupine. There is no impairment of the special 
senses. The sheep seem to hear and see as well and as correctly as under 
normal conditions of health. 

No indications of any disturbances of the digestive functions are to be 
seen. The appetite remains good, and the sheep eat up to the very last. 
They were observed eating industriously during the intervals between the 
attacks of spasms which they have during the last stages. 

At first the frequency of the pulse and of the respiratory movements 
is lessened and the temperature is lowered. The pulse remains very 
weak, but in the later stages becomes very rapid, in some cases 130 per 
minute. Toward the last also the respiration is very shallow and rapid. 
During the final convulsions the respiration is sometimes 120 per minute, 
but so shallow that the air is simply pumped up and down the windpipe. 
The air in the lungs is therefore not renewed, and the animal dies by 
asphyxia or suffocation. 

So long as the sheep can stand on its feet, or walk, it keeps up with 
the flock as nearly as possible. The exercise, however, excites it, makes 
its respiration more rapid, and it has frequently to lie down for a moment 
and then get up and hobble along after the flock. The worst cases can 
thus easily be detected, since they straggle behind the rest of the flock. 

The later stages follow rather rapidly. The involuntary movements 
become more frequent and more severe. All four legs tremble and shake 
violently. In fact, all the muscles of the body contract spasmodically until 
the animal totters over on its side and dies in the most violent spasms. 

Larkspur has the effect of arresting the heart's action and respiration 
and of paralysing the spinal cord. 

Treatment. Place the animal by itself in a cool, quiet, shaded place 
and avoid all excitement. Of the drugs tested, atropine sulj^hate dis- 
solved in camphor water has given the best results. Wilcox (Bull. 15, 
Montana Ex. Station) recommends for sheep from -^q to ^^ grain in the 
earlier, and J- to J grain in the later convulsive stages. Cattle require 
from four to five times these doses. Inhalations of ammonia vapour, 
and small doses of alcohol and ether, are also useful. 

In other cases very good results have been obtained from giving 




Fig. 81. — ■Delpliinium menziesii. 

(To illustrate " Larkspur Toisoning." From the Annual Keport, U.S.A. 
Department of Agriculture, 1898.) 




Fig. 82. — Delvhinium menziesii. 

(To illustrate " Larkspur Poisoning." From the Annual Eeport, U.S.A. 

Department of Agriculture, 1898.) 




Fig. 83. — Delpliinium scajjiilorum. 

(To illustrate "Larkspur Poisoning." From the Annual Report, U.S.A. 
Department of Agriculture, 1898.) 



PLANTS POISONOUS TO STOCK. 



233 



permanganate of potash in the form of a drench : 5 to 10 grams for an 
adult sheep or pig, 15 to 20 grains for a horse, and 30 to 50 grains for an 
ox, dissolved in a pint or two pints of water. 

* Delphinium ge:yeri.— The Wyoming larkspm' is^Yell known through- 
out Wyoming, Colorado, and Nebraska under the name of poison weed. 





Fig. 84. — Dwarf larkspur {DelpJiinium 
tricorne), one-third natural size. 



Fig. 85. — Cursed crowfoot {Ranunculus 
sceleratiis.) 



It is reported to be the most troublesome plant to stock in Wyoming, the 
dark-green tufts of foliage being especially tempting in spring when the 
prairies are otherwise dry and barren. 

Delphinium recurvatum. — This species of larkspur gro\YS in wet sub- 
saline soil in the southern half of California. It has been reported from 
San Luis Obispo county as fatal to animals. 

Delphinium scopulorum, — The tall mountain larkspur of the Eocky 
Mountains has been reported to the Canadian Department of i\.griculture 
as poisonous to cattle in the high western prairies of Canada. 

Delphinium trolliifolium. — This plant is common throughout the 
coast region of northern Cahfornia, Oregon, and Washington. In 



234 



POISONING. 



Humboldt County, CaL, it is known- as cow poison, on account of its 
fatal effect on cattle. Its toxic character has been questioned. Per- 
haps it is not equally poisonous throughout all stages of its growth. 

*Helleborus viridis. — The green hellebore is a European plant, some- 
times self-sown from gardens. All parts of the plant are poisonous. 
Cattle have been killed by eating the leaves. 



POISONING BY HELLEBORE. 

This form of poisoning is of slow progress, the plant producing 

irritation of the digestive mucous 
membrane. The symptoms con- 
sist in loss of appetite, blackish, 
glairy diarrhoea, and intermittence 
of the pulse. 

* Ranunculus sceleratus . — 

The cursed crowfoot, or celery- 
leafed crowfoot, is found through- 
out the eastern half of the United 
States and also in Europe. Cattle 
generally avoid all of the butter- 
cups, but fatal cases of poisoning 
from this plant are recorded in 
European literature. When dried 
in hay, the plant appears to be 
non-poisonous. The bulbous crow- 
foot (R. bidbosas) and the tall crow- 
foot {R. acris) are w^ell-known to 
be very acrid in taste, and it is 
probable that all of the species 
which grow in water or in very 
marshy land are poisonous. 

POISONING BY RANUNCULACE^. 
Fig. 86. — Mandrake {Podophyllum 

peltatum). Poisoning only occurs when 

the green plants are eaten. Dry- 
ing causes certain essences contained in them to disappear, and thus 
destroys their toxicity. 

This form of poisoning is indicated by yawaiing, colic, blackish, foetid 
diarrhoea, and rapid loss of strength. 

The animals suffer from stertorous breathing, weakness of the pulse, 
and aberration of vision. They die in convulsions. 




PLANTS POISONOUS TO STOCK. 235 

BERBERIDACE.E (BARBERRY FAMILY). 

Podophyllum peltatum. — The leaves of the common mandrake, or 
May apple, of the eastern half of the United States, are spanngly eaten 
by some cattle. Cases of poisonmg are very rare, but the experience 
of one correspondent shows that the milk from a cow that had been 
feeding on the plant off and on for about three weeks was so extremely 
laxative as to be positively poisonous. The accident occurred to a baby, 
fed exclusively on cow's milk. The physiological effect of the milk was 
precisely like that of mandrake. It was shown that the cow ate the plant, 
which w^as abundant in one pasture, and when the animal was removed 
to a j)asture free from the plant the child's illness stopped at once. 

BUTNERIACE^ (STRAWBERRY- SHRUB FAMILY). 

Butneria fertilis. — The large oily seeds of the calycanthus, or sweet- 
scented shrub, contain a poisonous alkaloid, and are strongly reputed to 
be poisonous to cattle in Tennessee. 

PAPAVERACE^ (POPPY FAMILY). 

Argemone mexicana. — The Mexican poppy is reputed to be poisonous 
to stock both in the United States and in New South Wales. The seeds 
are narcotic, like opium. 

* Chelidonium majus. — The yellow milky sap of the celandine, an 
introduced weed common in the eastern United States, contains both an 
acrid and a narcotic poison. Both are powerfully active, but cases of 
poisoning are rare, as stock refuse to touch the plant. Eeeks, of S^Dalding, 
however, describes {J. Comp. Path, and Therap., Dec. 1903, p. 367) an 
outbreak of poisoning by common celandine in wdiich tw^enty-one valu- 
able cow^s were affected and three died. The symptoms comprised exces- 
sive salivation and thirst, convulsions, unconsciousness and epileptiform 
movements. 

* Papaver somniferum, opium poppy, or garden poppy : P. rhceas, 
field poppy, red poppy, or corn poppy. — These plants are sometimes 
self-sown from gardens. Both contain acrid and narcotic poisons, and 
European literature records the death of various animals from eating 
their leaves and seed pods. 

POISONING BY POPPIES. 

The consumption of poppies causes arrest of peristalsis, secretion of 
foamy saliva, colic, depression, coma, and in severe cases death by 
stoppage of respiration. 



236 



POISONING. 



PRUNACE^ (plum FAMILY). 

*Prunus caroliniana. — The laurel cherry, or mock orange, is native 
in the south-eastern quarter of the United States, and is there often 
cultivated for hedges. The half-withered leaves and the seeds yield 
prussic acid, and are poisonous when eaten by animals. 

* Prunus serotina. — The wdld black cherry is a valuable forest tree 
which ranges throughout the eastern half of the United States. Cattle 

are killed by eating the partially 
withered leaves from branches 
thrown carelessly within their 
reach or ignorantly offered as 
food. The leaves of various other 
wild and cultivated cherries are 
probably poisonous to cattle in 
the same way. 

VICIACE^ (pea family). 

Aragallus lambertii. — The 

Lambert, or stemless loco weed, 
is, next to the following species, 
the best-known representative of 
a large group of closely related 
plants w^hich are native to the 
western half of the United States, 
and are known as loco weeds on 
account of the peculiar excited 
• condition which they induce 
in animals that eat of their 
leaves. Horses and cattle are both 
affected, but the chief damage is 
done to horses. After being per- 
mitted to graze on any of these 
plants the animal acquires an un- 
natural appetite for them, and soon refuses all other kinds of food. It 
rapidly becomes unmanageable, shows brain symptoms, and finally dies 
from lack of proper nourishment. 

Astragalus mollissimus. — This, the woolly loco w^eed, is perhaps the 
best known of all the loco weeds. It is the species most abundant in 
Colorado, where from 1881 to 1885 nearly $200,000 was paid out in 
bounties in an attempt to exterminate it. The plant is still abundant 
in that State, and reports of the damage done by it continue frequent. 




Fig. 87.— Black cherry {Prunus serotina) 
one-third natural size. 




Fig. 88. — AYliite loco weed {Argalliis spicatus) in flower. 
(From the Annual Eeport, U.S.A. Department of Agriculture, 1900.) 




Fig. 89. — White loco weed {Arg alius sj)icatus), showing seed pods. 
(From the Annual Report, U.S.A. Department of Agriculture, 1900.) 





* 










> ^ 


It 
4 








{t1 • 










1 » 




a'' 

» ■' ^ 






■^. i 




/ 


f 




- i, , . 








Ij.., 






^^f ^ 


' 




.. *X.^ 




'. , 






^ 


1 


l-y 










1 





FiCt. 90. — Loco weed [Astragalus splendens). 
(From the Annual Report. U.S.A. Department of Agriculture, 1900.) 



PLANTS POISONOUS TO STOCK, 



237 



Specimens of the three follo^Ymg species of Astragalus have been for- 
warded to the Division of Botany with the information that they were 
causing great financial loss in the districts noted. It is quite probable 
that other species are dangerous also. 

POISONING BY WHITE LOCO WEED (aRAGALLUS SPICATUS). 

This is an erect tufted perennial, 4 to 18 inches high, with pinnately 




Fig. 91. — Stemless loco weed 
[Aragallus lamhertii). a, 
Flowering plant; 6, seed 
pods ; c, cross-section of 
seed pod — all one - third 
natural size. 




Fig. 92. — Woolly loco weed {Astragalus 
mollissimus). a, "Whole ^olant ; h, sec- 
tion of pod — both one-third natural 



divided leaves and spikes of white or cream-coloured flowers, shaped like 
those of the pea. The pod is one-celled, and when shaken produces a 
rattling sound, which gives the plant the name of '' rattle weed " in some 
localities. The white loco weed is exceedingly common throughout Mon- 
tana. It occurs most abundantly on the northern slopes of foothills up 
to an altitude of about 8,000 feet. Its preferred habitat is for the most 



238 POISONING. 

part in rather dry sitaations. The habit of the plant varies in different 
parts of Montana. In some localities the flowers are pure white, while 
in others they are decidedly yellow. 

In Colorado the plant which is most ordinarily known as loco weed 
is Astragalus moUissimiis, while in Montana the species already named is 
perhaps most important ; but there are others which have a rather wide 
distribution and are known to produce the same effects. Among these 
may be mentioned A. splendens, A. lagopus, and A. hesseyi. 

The losses caused from the loco disease are very heavy in nearly all the 
Eocky Mountain States. The locoed condition is so commonly observed 
among sheep and horses that cases are not reported, and it is practically 
impossible to learn the exact extent of the disease. In the Judith Basin 
one prominent stockman was nearly ruined financially by the prevalence 
for a number of years of the loco habit among his sheep. In another 
instance the raising of horses was abandoned over a large tract of 
country on account of the loco weeds. 

The loco disease occurs under two forms — an acute and a chronic. 
An acute case of loco disease was observed by Dr. Wilcox in a two-year- 
old ewe with a lamb at its side. The ewe was observed eating large 
quantities of white loco weed on May 22nd, 1900. During the afternoon 
of the same day it became unmanageable, and the lamb was badly 
affected. An examination of the ewe at this time showed that it was 
completely blind and was affected with dizziness. It walked around in 
long circles to the right, and after a short period remained standing for 
a fe.w moments in a sort of stupor. At the beginning of each attack 
the head was elevated and drawn to the right ; eyelids, lips, and jaws 
were moved ra^^idly. Each attack lasted from one to two minutes> 
and the intervals between the attacks lasted about five minutes. The 
second day the attacks became more severe and of longer duration, the 
head being turned more decidedly to the right and the animal sometimes 
falling upon the ground. Similar symptoms, accompanied by digestive 
disturbances, were manifested by the lamb during the second day, and it 
died during the afternoon. On the morning of the third day it was 
found that the ewe was pushing against the fold, and had apparently 
been in that position during the greater portion of the night. The 
animal then began to whirl round to the right. Later it became unable 
to stand, and the spasmodic movements were largely confined to the legs. 
On the morning of the fourth day it died. The pupil of the eye was at 
no time dilated, and the expression was nearly normal. The pulse was at 
first very irregular, but on the second day became again regular and of 
normal frequency. The only remedy which was tried was frequent 
injections of one-quarter grain doses of morphine, but this was without 
effect. Two other ewes ate smaller quantities of loco weed at the same 



PLANTS POISONOUS TO STOCK. 239 

time and were similarly affected, but less severely. In these cases 
morphine was tried with better success. The lambs, however, died from 
the poisonous properties contained in the milk of the mother. 

The general symptoms of loco disease are quite familiar to all stock 
raisers. Perhaps the most characteristic are those of cerebral origin, and 
are shown in peculiarities of gait and action, w^hich may be compared to 
a drunken condition. The brain disturbances may consist in impairment 
of the special senses or in irregular motor impulses, wdiich produce inco- 
herent muscular action. In some cases the animal becomes blind. More 
frequently the animal makes errors in judgment of the size and distance 
of objects. These visual disturbances are often quite ludicrous. The 
animal often takes fright, apparently at imaginary objects, or at objects 
which under ordinary circumstances would cause no alarm. Locoed 
horses are somew^hat dangerous for driving purposes on account of their 
tendency to run away. Such horses are frequently attacked with kicking 
fits without any apparent cause. The sense of hearing is often affected, 
and the response to sounds is irregular and out of proportion to the 
volume and character of the sound. Irregularities in muscular move- 
ments of sheep may assume a variety of forms. The animal may simply 
carry its head in an extended or otherwise unnatural condition. In some 
cases the back is arched. Trembling is a characteristic symptom. In 
locoed horses a great difficulty is sometimes experienced in persuading 
them to go backw^ard. Locoed sheep are exceedingly difficult to manage. 
The different members of the flock may suddenly take a notion to run 
away in different directions, with the result that it is almost impossible 
for the shepherd to prevent their becoming separated. In cattle the 
disease appears to be rare, although symptoms, so far as observed, 
are essentially the same as those in sheep and horses. Occasionally 
locoed cattle manifest dangerous sjmiptoms, and attack men and other 
animals. 

In chronic cases of loco the animal gradually becomes more emaciated 
and crazy. In sheep the fleece may be shed in patches or as a w-hole. 
The animal becomes unable to care for itself, and is apt to fall into the 
water while attempting to drink. Fits of trembling are of frequent 
occurrence, and the animal finally dies of inadequate nutrition and total 
exhaustion. In chronic cases of loco disease in horses the animal is 
usually left to its ow^n resources on the range. During the later stages 
it may remain for weeks at a time upon a small area of ground without 
taking water. Dr. Wilcox saw a number of such cases in horses that 
were almost unable to walk. Under such circumstances the animals 
seldom or never lie down. One horse which was seen remained for a 
period of tw^o w^eeks, in 1897, upon a piece of ground about 150 feet 
square. During this time the horse had no water. 



240 POISONING. 

Numerous autopsies on locoed sheep and horses revealed slight con- 
gestion of the brain membranes in all cases. The lungs and heart were 
in normal condition. Fatty tissue was considerably reduced in quantity, 
and the muscles were paler in colour than under normal conditions. 

The most serious mistake in connection with loco disease is made in 
allowing locoed sheep to remain with the rest of the flock. The loco 
habit is apparently learned by imitation of locoed animals, and so long 
as locoed sheep are allowed to remain with other sheep the loco habit 
rapidly spreads. An experienced sheep raiser, after being nearly ruined 
financially through the loco disease, adopted the method of immediate 
isolation and the feeding of locoed sheep for mutton. His stock was 
replaced with sheep that w^ere free from the loco habit, and the trouble 
has been entirely eradicated from his range. 

No specific remedy for the loco disease has been discovered, and in 
the nature of the case no such remedy is likely to be found. In the 
present state of knowledge concerning the subject the only rational 
treatment to be recommended is that of confinement and feeding with a 
nutritious diet. By separating the locoed sheep at once from other sheep 
the spreading of the habit will be prevented, and the locoed animals may 
be fattened and thus prevented from becoming a total loss. Although 
locoed animals may readily be fattened and sold for mutton, their 
recovery from the loco habit is apj^arent only, and is due to their 
inability to obtain the loco weed. Such animals when allowed to run 
upon the range again almost invariably return to their old habit of 
eating loco weed. Animals which have once been locoed are, therefore, 
unsuitable for stocking the range. 

In combatting the loco disease the most rational methods include 
providing salt for the sheep, the immediate removal of locoed sheep 
from the band, confining them in a fold, and feeding them upon a 
nutritious diet. They may thus be fed for market, and tbeir pernicious 
habit will not spread to other sheep. In the case of locoed horses, an 
apparent recovery takes place if they are confined in a stable and fed on 
ordinary cultivated forage or allowed to run in pastures where no loco 
weeds are found. Such horses are always somewhat dangerous, and 
more apt to run away or become unmanageable than horses which have 
not become affected with this disease. 

* Crotalaria sagittalis. — The rattlebox (rattle weed ; wild pea) is an 
annual weed which grows on sandy soil throughout most of the eastern 
half of the United States. In some years it is especially abundant in the 
bottom lands of the Missouri Valley. Horses and sometimes cattle are 
killed in this region by eating grass or meadow hay which is contami- 
nated with the plant. 



PLANTS POISONOUS TO STOCK. 



241 



Lupinus leucophyllus. — This herbaceous shrub is a representative of 
a very large genus of plants, many of which are widely and abundantly 
distributed throughout the western United States, and are generally 
known as lupines. The above species is very abundant in Montana, 
where it is said to have caused the death of a very large number of 
sheep. There is some question whether the animals are killed by a 
poisonous constituent of the plant 
or merely by tympanites. The seeds 
of all the lupines are probably dele- 
terious in the raw state. In Europe, 
however, the seeds of Lvpinus albus, 
after the bitter taste has been re- 
moved by steeping and boiling, are 
eaten by human beings as well as 
by cattle. 

POISONING BY LUPINES (lUPINUS 
LEUCOPHYLLUS ; L. SEPvICEUS ; L. 
CYANEUS). 

These plants are commonly 
known by the names blue pea, 
blue bean, and wild bean. They 
are coarse, silky-haired perennial 
herbs, with blue flowers arranged 
in conspicuous terminal racemes, 
which blossom in June and July, 
with long- stemmed leaves, which 
are divided into from seven to 
eleven leaflets radiating from a 
common point. The fruit is a hairy, 
several- seeded pod, and the seeds 
are small and somewhat flattened. 

As a rule these plants do not 
occu^: in the flat river bottoms. 

They occur most abundantly on the foothills and mountain ranges at 
moderate elevations. 

During the season of 1900 the lupines in Montana began to bloom 
about May 20th, and the first full pods were collected on June 5th. 
Lupines are not very extensively eaten by sheep during the spring and 
summer, except when they are unusually hungry or are being driven 
from one range to another. Lupines are more often eaten by sheep in 
summer on the mountain sides, and in the fall and early winter after 

D.C. R 




Fig. 93. — Eattle box {Crotalaria sagit- 
talis). a, Whole plant; 6, cross-section 
of seed pod— both one-thnd natural 
size. 



242 POISONING. 

early frosts have opened the pods and the seeds have fallen out. Lupme 
hay is greedily eaten by all kinds of stock during the winter, and large 
quantities of this hay have been fed for the past fifteen or t^Yenty years. 
Lupine hay is cut in different years at dates ranging from the 1st of 
July to the middle of September. When cut during the first half of July 
the newly ripe pods, full of seeds, are secured in the hay. When, how- 
ever, the harvesting of lupine hay is postponed until September, the 
pods become ripe and split open, and the majority of seeds fall out. A 
striking variation in the quantity of pods containing seeds is noted 
during different years. Daring seasons in which May and June are wet 
the quantity of pods is usually large. When, however, these months are 
dry only a few pods are found on each plant, and a vast majority of the 
flowers fail to be fertilised. 

Dr. Wilcox has observed that sheep are especially fond of the pods of 
various leguminous plants before they become mature and while they are 
still in a succulent condition. 

Dr. Wilcox saw a flock of sheep which while being driven from one 
range to another, in a hungry condition, was allowed to feed upon an 
area of lupines in a nearly ripe condition. Within two hours the sheep 
manifested violent symptoms of poisoning, and ultimately 100 out of the 
lot of 200 died. He afterwards saw many hundreds of fatal cases in 
sheep and a number in horses, both from eating green lupines and 
lupine hay. 

As an experiment two sheep were given each 150 medium-sized 
lupine pods (L. leucopJiyllus) which were entirely full of ripe seeds. The 
sheep ate the pods readily. Both sheep became frenzied within about 
forty-five minutes after feeding upon the lupine pods, and died about one 
hour later. The symptoms in these cases were the same as those 
observed in poisoning under natural conditions. 

The symptoms of lupine poisoning are so well known in Europe 
that chronic lupine poisoning has been given the name lupinosis. It is 
characterised by loss of appetite, fever, dyspnoea, constipation, and yellow- 
ness of the visible mucous membranes. Diarrhoea, sometimes of a san- 
guinolent type, appears later. The urine becomes albuminous, tinted with 
bile products or stained red by haemoglobin, and the head shows oedema. 
Death occurs in a few days. In America the chronic form has not been 
observed. In cases of lupine poisoning in Montana there was noted 
acute cerebral congestion, accompanied with mental excitement. The 
sheep rushed about in different directions, butting one another and other 
objects. The first stage of frenzy was soon followed by a second stage, 
characterised by pronounced irregularity of movement, spasms, and 
falling fits. In the majority of cases death occurred in from one-half to 
one and one-half hours. In extensive cases of lupine poisoning it was 




Fig. 94. — Lupine {Lupiniis leucophyllus). 
(From the Annual Report, U.S.A. Department of Agriculture, 1900.) 








Fig. 95. — Lupine (Liqjiiuis leucophyllus) in hay. 
(From the Annual Report, U.S.A. Department of Agriculture, 1900.) 



PLANTS POISONOUS TO STOCK. 243 

uniformly observed that a number of the sheep lingered on from two to 
four days before they died. The muscular convulsions resembled those 
caused by stiychnine. The excretion of the kidneys was much increased 
and frequently was bloody. Post-mortem examinations of sheep poisoned 
by lupines revealed conditions similar to those in acute forms of loco 
disease, with the addition of a congested condition of the kidneys. 

No remedies have been tried in cases of poisoning from American 
species of lupine, but it seems reasonable to suppose that potassium 
permanganate would probably destroy the lupine alkaloids in the stomach 
if administered promptly after the first signs of poisoning. Experience 
and observation indicate that lupine hay is always dangerous for sheep if 
cut at a time when the seeds are retained in the hay. The evidence thus 
far collected regarding this matter indicates that the seeds are the most 
poisonous part of the plant. 

POISONING BY VETCHES (lATHYRUS SATIVUS) : LATHYRISM. 

In the horse this disease is due to feeding on grain containing 
the seeds of vetches, but in the ox to eating the green portions of the 
plants. Feeding has to be continued for at least a month to produce 
accidents. 

The earliest symptoms consist in suppression of milk secretion, and 
somnolence. Nervous symptoms — -from which alone the horse suffers — 
soon make their appearance. The neuro-muscular system is attacked. 
Interference with the nervous system is followed by inco-ordination of 
movement, and later by paraplegia of the hind quarters. Eoaring is not 
noticeable, probably because the patients rarely move rapidly. 

The lesions have been little studied, but appear to consist in con- 
gestion and infiltration of the meninges, cord, and roots of the lumbo- 
sacral plexus. 

Treatment. If the animals are paralysed, treatment is rarely of 
value ; otherwise it is sufficient to remove the cause and to administer 
purgatives and diuretics, with the object of eliminating toxic products. 
Kecovery follows in three to four weeks. 

Robinia pseudacacia. — The common locust tree is native in the 
central and eastern parts of the United States, and is extensively 
cultivated for ornamental purposes throughout the Union. The bark 
and leaves contain a powerful poison, and persons have been killed by 
eating these parts. 

* Sophora secundiflora.— The beautiful bright-red beans of the frijo- 
lillo, or coral bean, of southern and western Texas contain a powerfully 
poisonous alkaloid. The plant is said to have poisoned stock in Texas 
and in northern Mexico. 

R 2 



244 



POISONING. 



LINAGES (flax FAMILY). 

Linum rigidum. — The large-flowered yellow flax is reported from 
Pecos Valley, Texas, as poisonous to sheep. An investigation made by the 
Bm-eau of Animal Industry, U.S.A., showed that the plant is poisonous. 





Fig. 96. — Caper spurge {Evpliorhia 
latliyris). a, Upper half of plant, 

• one-third natural size ; &, seed 
capsule, natural size. 



Fig. 97. — Snow on the mountain {Eu- 
Ijliorhia ynarginata). a, Whole plant^ 
one-third natural size ; b, seed capsule, 
natural size. 



MELIACEJE (UMBKELLA-TREE FAMILY). 

* Melia azedarach. — The Chinese umbrella tree is much cultivated 
for ornament, and sometimes grows wild in the South. A correspondent 
from Arizona stated that three of his hogs were poisoned by eating the 
seeds, which were ignorantly offered to them for food. 



* EUPHORBIACE^ (sPURGE FAMILY). 

Euphorbia. — There are many species of spurge native to the United 
States, nearly all of which contain an acrid milky juice. Stock generally 



PLANTS POISONOUS TO STOCK. 



245 



avoid them, but cattle have been poisoned by drinking water into which 
the plants have been thrown. The juice of E. marginata and E. hicolour 
is used to some extent in Texas to brand cattle, it being held to be 
superior to a red-hot iron for that purpose, because screw worms will not 
infect the fresh scar and the spot heals more readily. 

* Jatropha stimulosa. — The seeds of the sjDurge nettle of the Southern 
States are extremely poisonous. Stock avoid the plant on account of its 
stinging hairs. 

*Ricinus communis. — The castor oil plant is quite commonly 





Fig. 98. — Castor oil plant (Bicinus 
communis). 



Fig. 99. — Eed chestnut {Msculus j^avia). 
a, Flowering branch ; b, seed — both 
two-ninths natural size. 



cultivated in the warmer portions of the United States, and grows 
wild in the South. The seeds have been accidentally eaten by 
horses with fatal effect, and they have been strewn on pasture lands 
in the North-West for the purpose of killing sheep that were tres- 
passing thereon. A Frenchman has discovered a method of making 
cattle immune to the effects of the toxalbumin contained in the 
seeds, so that they may be fed to stock without causing any ap- 
parent ill effect. A note on poisoning by castor oil cake will be 
found hereafter. 



246 



POISONING. 



BUXACE^ (box family). 

* Buxus sempervirens. — The leaves of the common box, cultivated 
for hedges, are poisonous to all kinds of stock. 



^scuLAc^ (horse-chestnut family). 

^sculus californica, California buckeye: M. glabra, Ohio buck- 
eye ; foetid buckeye : M. hippo- 
castanum, horse - chestnut : M. 
pavia, red buckeye. — The leaves 
and fruit of these species are 
generally regarded as poisonous 
to stock. The fruit may be easily 
converted into food by washing 
and boiling. It is believed that 
a small quantity of the unpre- 
pared fruit of the California buck- 
eye will cause cows to slip their 
young. 

HYPERICACE^ (ST. JOHN's WORT 

family). 

* Hypericum perforatum. — 

The common St. John's-wort is 
commonly believed to cause dis- 
agreeable eruptions on cows' 
udders and on the feet of white 
haired animals. This species 
and the spotted St. John's wort 
{H. maculatum) were brought into 
the United States Bureau of Agri- 
culture by Dr. G. W. Bready, from 
Norwood, Maryland, who stated 
that five horses were poisoned in 
May, 1898, by eating meadow hay 
of these plants. One horse died 
two were killed to prevent their 




Fig. 100. — Water hemlock (Cicuta macu- 
lata), showing section of spindle-shaped 
roots and lower stem, the leaves, flowers, 
and fruit, one-half natural size ; also fruit 
and cross-section of seed, enlarged five 
times. 

which contained nearly 50 per cent. 
from the effects of the poison, and 
further suffering. 



POISONINCx BY ST. JOHN S WORT. 



The ingestion of St. John's wort produces excitement foUow^ed by dul- 
ness, interference with vision and hearing, and by visual hallucinations 



PLANTS POISONOUS TO STOCK. 



247 



with a tendency to lean backwards, the front hmbs remaining fixed in 
position. The patient often sits down on the hind quarters Hke a dog. 

APIACE^ (CARKOT FAMILY). 

* Cicuta maculata. This is the water hemlock (spotted hemlock; 
beaver poison ; cowbane), which grows most abundantly throughout the 




Fig. 101. — Oregon water hemlock (Cicuta 
vagans). a, Plant with leaves, one-sixth 
natural size ; h and 6^, rootstock and 
horizontal roots, showing section, half- 
size ; c, terminal leaflets, one-sixth na- 
tm^al size ; cl, flowering spray, full size. 




Fig. 102. — Poison hemlock (Conium mac- 
ulatum), showing upper portion of 
plant with flowers and seed, one-third 
natural size. 



United States. It is one of the best known poisonous plants. Stock are 
not infrequently killed by eating the fleshy roots or hay with which the 
plants are mixed. 

* Cicuta vagans. — Cattle are frequently killed in Oregon and 
Washington by eating the large fleshy rootstocks which have been 



248 



POISONING. 



washed, frozen, or dug out of the soil, or by drinking water in marshes 
where the roots have been trampled upon. The roots of the other 
species of Cicnta are undoubtedly poisonous, but cases have been 
reported against one other species only, namely, C. holanderi. It grows 
in marshy land in California. 

* Conium maculatum. — The well-known poison hemlock, or spotted 
hemlock of Europe, is an introduced weed not uncommon in the north- 
eastern section of the United States and in California. The plant is 




Fig. 103. — Narrow-leaf 
laurel {Kahnia an- 
gustifolia), showing 
flowering branch, one- 
third natural size. 




Fig. 104. — Broad-leaf laurel {Kahnia latifolia). 
«, Flowering spraj', one-third natural size ; 
6, vertical section of flower showing pecu- 
liar attachment of stamens, natural size ; c, 
fruiting capsules, natural size. 



generally avoided by stock on account of its bad odour, but animals 
have been killed by eating it in the fresh state. Since the poisonous 
constituent is volatile, the dry plants are not so dangerous. 



POISONING BY HEMLOCK AND WILD CHERVIL (aNTHRISCUS SYLVESTRIS). 

Poisoning only results from ingestion of the green plants. It is 
characterised by salivation, nausea, dyspnoea, generalised trembling and 
vertigo, paraplegia, and symptoms of gastro-enteritis. 



PLANTS POISONOUS TO STOCK. 



249 



POISONING BY FENNEL. 

This disease, seen in Algeria, and recently studied by Bremond and 
Bojoly, need only be mentioned. The information at present available 
is indefinite, and the symptoms so closely resemble those of Texas fever 
that there seems a possibility of 
confusion having arisen. 

The lesions are those of hemor- 
rhagic gastro-enteritis. 

Treatment consists in gi^dng 
tannin, opium, and emollients. 



Oxypolis rigidus. — The cowbane 
is natural in swamps throughout 
the eastern half of the United 
States. The leaves and roots are 
reputed to be poisonous to cattle. 

Slum cicutaefolium. — The leaves 
of the hemlock water parsnip, which 
is more or less common throughout 
the United States, are said to be 
poisonous to stock. 

ERICAE.E (heath FAMILY). 

Andromeda p o 1 i f o 1 i a. — The 

wild rosemary, or moorwort, is a 
plant native to the northern regions 
of Europe, Asia, and America, en- 
tering the United States only in 
the extreme north-east. The leaves, 
which have been eaten by sheep 
with fatal effect, contain a narcotic poison known as andromedotoxin. 
The plant is not very dangerous in its native habitat, because it grows 
in bogs which are inaccessible to stock. 

* Azalea occidentalis. — The California azalea is very much dreaded by 
sheep men who "drive their flocks into the southern Sierras for pasture. 
Investigation has shown that the leaves contain a poisonous substance. 

* Kalmia angustifolia.— The narrow-leaf laurel is abundant in the 
north-eastern section of the United States, where it is also well known 
as sheep laurel and lamb-kill. The leaves contain andromedotoxin, 
and sheep and calves are frequently poisoned by eating them. 

* Kalmia latifolia.— The broad-leaf laurel is native throughout the 
greater part of the eastern half of the United States, and is known by 




Fig. 105. — Branch ivy {Leucothoe cates- 
hcei). a, Flowering branch ; h, fruiting 
capsules. 



250 



POISONING. 



a great variety of common names, the most important of which are 
laurel and ivy. The latter name is-most commonly used south of Mary- 
land. Scores of cattle and sheep are poisoned annually by eating the 
plant. It is probably the most dangerous of all the shrubs belonging 
to the heath family. 

* Leucothoe catesbsei. — This is the branch ivy, hemlock, or calf-kill, 





Fig. 106. — Staggerbush [Pieris mari- Fig. 107. — Great laurel {Rhododendron maxi- 
ana), showing flowering branch, mum). «-, Flowering branch ; b, fruiting 

one-third natural size. capsules — both one-third natural size. 

of the Allegheny Mountains. It is well known in that region to be fatal 
to all kinds of stock. 

* Leucothoe racemosa. — The swamp Leucotlioc of the Atlantic and 
Gulf States has been reported from New Jersey as especially fatal to 
calves. 

* Pieris mariana. — The stagger bush of the Atlantic Coast region, 
Tennessee, and Arkansas is commonly known to be poisonous to 
calves and to sheep. The name stagger bush was applied to the 
shrub on account of the peculiar intoxicating effect of the leaves. 

* Rhododendron californicum. — The California rhododendron is 



PLANTS POISONOUS TO STOCK. 



251 



native on the Pacific Slope from San Francisco to British Columbia. 
The plant is rejDorted from Oregon as poisonous to sheep. It is quite 
probable that the leaves contain andromedotoxin, but they have not 
been tested. 

* Rhododendron maximum. — The great laurel (rosebay ; moun- 
tain laurel ; rhododendron) is a large evergreen bush or small tree which 
is quite commonly cultivated for ornament, and 

is found native in the Allegheny Mountains. The . 

leaves contain andromedotoxin, and they are occa- 
sionally eaten by stock with fatal effect. 

PRIMULACE^ (PKIMROSE FAMILY). 

Anagallis arvensis. — The pimpernel is a 
European plant which has obtained a specially 
strong foothold in California, where it grows 
luxuriantly and is sometimes known as poison 
weed. It is suspected of having caused the death 
of a horse at Santa Ana. Chemists have isolated 
a powerfully poisonous oil and a strongly active 
ferment from the plant. 

OLEACEiE (olive FAMILY). 

Ligustrum vulgare. — The privet, or prim, is 
a garden shrub, introduced from Europe and 
Asia, which is much used for hedges, and has 
escaped from cultivation in western New York 
and southward to North Carolina. Accidents have 
been occasioned in children both by the fruit and 
the leaves. The plant is to be suspected in cases 
of poisoning in animals. 

APOCYNACE^ (dogbane FAMILY). 

Fig 108. —Milk Vv^^d 
Apocynum androssemifolium, spreading dog- {Asdepias eriocarpa), 
bane: A. cannabinum, Indian hemp. — These one-sixth natural size, 
plants are generally distributed throughout the 

United States. Stock generally avoid them in pasture fields on account 
of their acrid milky juice. When dry they are not so poisonous as when 
in the fresh state. 

Nerium oleander. — The oleander is a common house plant throughout 
a large portion of the United States. It grows freely out of doors in 
the Southern and Western States, and has probably escaped from culti- 
vation in some places. It grows wild in northern Mexico. The leaves 




252 



POISONING. 



are well known to be most powerfully poisonous, and stock are occa- 
sionally killed by eating them. 



ASCLEPIADACE^ (MILKWEED FAMILY). 

*Asclepias eriocarpa. — This is the plant with broad mullein-like 
leaves which is known as milkweed in California. Several authentic 

accounts of the poisoning of 
sheep have been secured 
against the plant in Men- 
docino County. It is es]3e- 
cially feared on very warm 
days by sheep men when 
they are compelled to drive 
their flocks through dry, 
barren valleys. It sometimes 
grows on cultivated land, and 
is cut with hay. 

* Asclepias syriaca. — This 
is the common milkweed, or 
silkweed, of the north-eastern 
quarter of the United States. 
Experiments show that the 
milky juice so abundant in 
all parts of the plant is very 
acrid and poisonous. It is 
listed among the poisonous 
plants of Europe. 

SOLANACE^ (potato FAMILY). 

* Datura stramonium: 
D. tatula. — These two species 
very closely resemble each 
other, and are most com- 
monly known in the United 
States by the name of jimson 

weed. They are European plants which have become weeds in waste 
grounds and about dwellings throughout the greater portion of the 
country. One or two instances are recorded in which cattle have been 
poisoned by eating hay containing the young leaves. 

* Hyoscyamus niger. — The black henbane is an ill-smelling plant, a 
native of Europe, now naturalised in Michigan, and from New York north- 
ward. One or two cases are recorded in European literature in which stock 




Fig, 109. — Jimson weed {Datura stramonium). 
a, Flowering spray ; h, fruiting capsule — both 
one -third natural size. 



PLANTS POISONOtrS TO STOCK. 



253 



have been poisoned by eating the plant of their own accord, but there 
is very Httle danger from it, on account of its ill odour and harsh 
texture. 

* Nicotiana tabacum. — This is the tobacco most commonly cultivated 
in the United States. It is native to South America and has escaped 
from cultivation to some extent in the Southern States. According to 
some authorities stock are not always disposed to shun this plant on 
account of its characteristic ill odour and taste, but, on the contrary. 





Fig. 110. — Bittersweet {Solarium dulca- 
mara), a, Flowering spray ; h, fruit — 
both one -third natural size. 



Fig. 111. — Black nightshade {Sola- 
num nig ruin), one - third natural 
size. 



will eat a small amount of the leaves with apparent relish, especially 
when they are somewhat fresh. Stock have, however, been poisoned by 
eating leaves which were placed within their reach to dry, and also by 
eating food contaminated with the juice of the leaves. Considerable 
precaution should be used in applying tobacco juice to fresh cuts or 
bruises in stock, as the poison is easily absorbed into the system and 
may prove fatal. There are several native species of tobacco in the 



254 



POISONING. 



western half of the United States, all of which are undoubtedly poisonous 
if eaten even in moderate quantity. 



TOBACCO POISONING. 

Tobacco poisoning may be produced by baths or lotions containing 
tobacco juice, which is often used as a parasiticide. The ingestion of 

tobacco leaves in forage may also 
produce poisoning. Doses of 1 ounce 
in the goat and 10 ounces in the ox 
are toxic. 

The symptoms consist in sali- 
vation, vomiting, nausea, diarrhoea, 
cardiac palpitation and dyspnoea. 

The lesions are those of gastro- 
enteritis with cerebral congestion. 

Treatment consists in giving 
tannin, black coffee, etc. 

Solanum dulcamara. — The 

bittersweet, or climbing night- 
shade, is a European weed, now 
introduced in the north - eastern 
quarter of the United States. The 
leaves are suspected of being poi- 
sonous to stock. 

* Solanum nigrum. — The black 
nightshade (common nightshade ; 
garden nightshade) is a common 
weed in cultivated fields throughout 
the greater portion of the United 
States. Cattle seldom eat the plant, 
but a few cases of poisoning are 
recorded for calves, sheep, goats, 
and swine. 
* Solanum triflorum. — The spreading nightshade is a native of the 
Great Plains (United States), and also a common garden weed from 
Arizona and Texas to British America. Complaints of the poisoning 
of cattle by this plant have been sent to the Department of Agriculture 
from Nebraska. Experiments show that the berries are poisonous. 

Solanum tuberosum. — ^The small, immature tubers of the common 
cultivated potato and those that have turned green from exposure to 
the sun are slightly poisonous. The green fruit and the white sprouts 




Fig. 112.— Spreading nightshade {Sola- 
num triflorum), one-third natural size. 



PLANTS POISONOUS TO STOCK. 



255 



from mature potatoes are likewise poisonous. In all of these cases the 
deleterious substance may be removed or destroyed by thorough boiling. 



SCROPHULARIACE^ (fIGWORT FAMILY), 

Digitalis purpurea.— The purple foxglove is a common garden plant 
which has sparingly escaped from 
cultivation and is naturalised to 
some extent on Cape Breton Island. 
Horses are occasionally poisoned 
in Europe by nipping the plants 
from gardens or by eating hay 
contaminated Avith it. 

Gerardia tenuifolia. — The 
slender gerardia is native to the 
eastern half of the United States, 
and has been specially reported as 
poisonous to sheep and to calves 
in the Southern States. 

Gratiola officinalis. — The hedge 
hyssop of the Southern States 
contains an acrid poison. The 
same plant grows in Europe, and 
is there regarded as poisonous to 
stock. 

Pedicularis. — The plants of this 
genus are commonly called louse- 
wort. In Europe several species 
are suspected of being slightly 
poisonous to stock. One of these, 
P. palustris, occurs in Labrador, 
and there are over thirty species 
native to the United States, largely 
Western. They should all be suspected of being poisonous. 




Fig. 113. — Sneezeweed {Helenvmn au- 
tumnale), one-third natural size. 



CAMPANULACE^ (beLL-FLOWER FAMILY). 

Lobelia inflata, Indian tobacco : L. kalmii, brook lobelia : L. spicata, 

pale-spiked lobelia : L. syphilitica, great lobelia. — All of the species in 
this genus contain an acrid and usually milky juice, and are poisonous. 
None has been specially reported as poisonous to stock, but the above- 
named species are to be suspected, because they frequently occur in 
grass and are sometimes found in meadow hay. 



256 POISONING. 

AMBROSIACE.E (RAGWEED FAMILY). 

Xanthium canadense. — The young seedlings of the American cock- 
lebur are reported from Texas as being rapidly fatal to hogs. 

Xanthium spinosum. — The spiny clotbur is suspected of being poi- 
sonous, but few cases have been definitely recorded against it. The 
seeds apparently contain a toxic compound. 

Xanthium strumarium. — The young seedlings of the broad cock- 
lebur are reported from Georgia as being fatal to hogs. Experiments 
seem to show that the seed is poisonous. 

CARDUACE.E (thistle TAMIL y) . 

*Helenium autumnale.— Sneezeweed (sneezewort ; autumn sneeze- 
weed ; stagger weed; false sunflower) is found throughout the greater 
portion of the United States, being most abundant in the Southern and 
Eastern States. Sheep, cattle and horses that are unfamiliar Avith the 
plant are often poisoned by it when driven to localities where it is abun- 
dant. Stock avoid it, as a rule, but it is claimed that they sometimes 
develop a taste for the plant, and are killed quickly by eating it in large 
quantity. 

Senecio jacobsea. — The tansy ragwort, or stagger wort, is a European 
plant which grows as a weed in ballast about New York and Philadelphia. 
Farther north, in Nova Scotia, it has become extensively naturalised, and 
it is there regarded by stock men as poisonous. It is interesting to 
note that S. guadalensis of Mexico is also considered fatal to stock. 



COLCHICUM POISONING. 



Fodder of bad quality often contains leaves, flowers, and particularly 
seeds of colchicum, which produce nausea, vomitmg, colic and diarrhoea. 
The colchicine acts particularly on the kidney and heart, producing 
specific disturbance, indicated by hsematuria, polyuria, and cardiac pal- 
pitation, with lowering of the body temperature. 

Even when poisoning is not fatal, it is very apt to produce abortion. 

POISONING BY ANNUAL MERCURY. 

Annual mercury given in green fodder is stated to produce indiges- 
tion, diarrhoea, vesical and intestinal haemorrhage, and early death. 
Some authors, however, deny that it has such toxic properties. 

POISONING BY BRYONY. 

In large doses all parts of the bryony plant are toxic — the root, stalk, 
and leaves. 



POISONING BY COTTON CAKE. 257 

Biyony is sometimes used as a pm-gative. Poisoning is characterised 
by nausea, s>Yeating, diuresis, frequent action of the bowels, and, in grave 
cases, by tetaniform convulsions followed by death. 

POISONING BY CASTOK OIL CAKE. 

Causation. Excessive use of this form of cake is the usual cause 
of such poisoning, though bad quality is also an important factor. The 
castor oil beans are often insufficiently crushed and compressed, so that 
a considerable amount of oil is contained in the cakes as sold ; but the 
most dangerous constituent is undoubtedly the material known as ricin, 
which, in some specimens of cake, may exist in highly dangerous 
quantity. 

The oil contained in the cake, like every other fatty substance, 
favours intestinal peristalsis and the onward movement of the digested 
food. The laxative principle excites secretion, and if the cake be given 
for considerable periods, the most serious consequences may ensue. 

Cakes prepared from mixed rape seed and castor beans act in a 
similar way, though in a longer or shorter time, according to their rich- 
ness in ricin. 

The earliest symptom consists in purgation, which gradually de- 
velops into superpurgation, and is followed by direct irritation of the 
muscous membrane, indicated by serous, foetid, and sometimes san- 
guinolent, diarrhoea. The symptoms may appear in twenty-four hours. 
They are usually accompanied by a rise in temperature of 2° to 3° Fahr. 
Secretion of milk ceases, and animals heavy with young sometimes abort. 
In exceptional cases death follows. 

The lesions are those of hsemorrhagic enteritis. 

Treatment is principally of a preventive character. The cakes should 
be examined, and if they contain insufficiently crushed seeds or beans 
should be discontinued or given in smaller quantities. The proportion 
of ricin in mixed rape and castor cakes should be determined. 

Curative treatment consists in removing the cause and treating the 
enteritis. The latter is best controlled by giving emollients, diuretics, 
and mucilaginous drinks prepared from linseed, marsh-mallow, barley, etc. 

POISONING BY COTTON CAKE. 

Cotton cake forms a rich food, which fattens animals very rapidl}^ 
but given in excess may produce true poisoning, and if prepared from 
undecorticated seed may produce mechanical irritation ending in ob- 
struction of the bowel. 

The latter accident occurs only in the sheep. It consists in ob- 
struction of the omasum (oesophageal gutter), and particularly of the 
D.c. s 



258 I^OISONING. 

abomasiim, by the woody seed covering, the fibres of which become 
agglutinated and close the pyloric opening, just as do the fragments of 
wool or the hairs in animals affected with the licking habit (pica, de- 
praved appetite). The mass thus formed passes into the intestine, and 
is apt to become fixed at some point and to cause death. 

In the ox, as in the sheep, true poisoning may result from, the action 
of an injurious principle which Cornevin discovered in the seed and 
particularly in the meal. The relative rarity of such accidents is 
explained by the composition of the cakes, which are rich in husks but 
poor in meal. 

In the first series of accidents the symptoms resemble those pro- 
duced by the intestinal obstructions peculiar to the licking disease ; in 
the second they appear about the eighth to the fifteenth day, and are 
indicated by sensitiveness of the abdomen and by efforts to pass urine. 
The urine is albuminous ; at a later stage it becomes darker in colour, 
reddish, and stained with haemoglobin. The mucous membranes exhibit 
a sub-icteric tint. 

Lesions. The liver shows interstitial hepatitis, consequent on changes 
in the hepatic cells due to the poisonous principle. The kidney first 
shows lesions of interstitial, but afterwards of epithelial, nephritis ; the 
endothelium of the tubes appears to be undergoing proliferation. 

Treatment should only be undertaken when the organic lesions 
seem trifling, and suggest the possibility of cure without excessive 
outlay. Under such circumstances it is sufficient to remove the cause 
and to supply proper diet. 

POISONING BY MOLASSES REFUSE. 

Molasses refuse is much used about Paris and in the department of 
Le Nord for fattening or simply for feeding animals. Added to rough 
fodder, even of poor quality, the refuse renders it palatable, and thus 
forms an economic food ; it also improves the condition of animals with 
broken wind. Its poverty in nitrogenous materials (the refuse consists 
of 60 per cent, of hydrocarbons ; 10 to 12 per cent, of potash and soda 
salts) renders it necessary to enrich it in this respect. Moreover, only 
a limited quantity should be given. If given in larger amounts than 
2 to 2J parts per 500 parts of body weight it may produce bad effects. 
In this case the earlier symptoms point to interference with the urinary 
apparatus, the digestive apparatus being affected later ; both accidents 
are due to the potash and soda salts present in the refuse, and may 
become so well marked as to constitute true poisoning. 

The symptoms consist in abundant diuresis, resulting from the 
excess of potash and soda salts, and are followed by albuminuria. Super- 
purgation is usually present. 



DISEASES PRODUCED BY DISTILLERY AND SUGAR FACTORY PULP. 

Lesions. On post-mortem examination one finds lesions of irritant 
gastro-enteritis, and of chronic nephritis. 

Treatment consists in withdrawing the molasses refuse, and giving 
milk, mucilaginous fluids, barley water, and cereals, which soothe the 
kidney. 

DISEASES PRODUCED BY DISTILLERY AND SUGAR FACTORY PULP. 

This disease, which is very common in France and Germany, results 
from feeding on distillery and sugar factory residues, consisting for the 
most part of beet pulp. 

In 1860 Guionnet described it under the name of disease of the 
abomasum, and more recent work by Butel, Rossignol, and Arloing has 
thrown a great deal of light on its exact nature. 

Causation. Guionnet attributed the injurious action of beet pulp, 
etc., to excess of acidity, due to the addition of sulphuric acid during 
manipulation in the factory; but it has since been shown that this acidity, 
if existing, is specially due to various fermentation products, the results 
of lactic, butyric, aud acetic fermentation, etc. 

Rossignol regarded the symptoms as wholly due to the excessive 
proportion of water, viz., 90 per cent. ; but this does not explain the 
general symptoms of poisoning. 

The real cause is to be sought in the manner of preserving the pulp 
in simple earth silos or in cemented silos, where it undergoes fermenta- 
tion and putrefaction. The contained liquid is then extremely toxic. 
Filtered through porcelain and injected under the skin, it produces 
vaso-motor and vaso-paralytic disorder, identical with that seen in acute 
forms of the disease ; in other cases it excites abnormal secretion, and 
leads to permanent diarrhoea and chronic gastro-enteritis. 

This liquid, if injected intravenously, may prove toxic in doses 
of 2 to 3 cubic centimetres per kilogram of bodily weight. Its in- 
jurious effect is due to toxins secreted by special bacilli, w^hich were 
isolated and studied by Arloing. The toxicity diminishes as the pulp 
becomes older, and can be avoided by adding antiseptics like common 
salt, which prevent fermeutation. These experiments of the Lyoiis 
professor are certainly very interesting, and, although perhaps not 
identical with what occurs in practice, sufficiently indicate the way in 
which poisoning occurs. 

Pathological disturbance only follows the use of decomposed pulp. 

Animals reared on farms where distillery and sugar factory pulp is 
regularly given become accustomed to it, and are rarely affected. The 
chief sufferers are those recently imported, or recently placed on such 
food ; in them the disease may assume either the acute, nervous, sub- 
acute, or chronic form. 

s 2 



260 POISONING. 

Acute form : Symptoms. This form is exceptional in the ox, but 
is more frequent in the sheep. In oxen the earher symptoms ]3oint to 
digestive disturbance, and consist of dulness, loss of appetite, colic, 
sensibility of the abdomen, cessation of rumination (without tympanites), 
and constipation. The excreta are hard, coated, and blackish in colour, 
but not blood-stained. 

Diarrhoea follows, is accompanied by aggravation of the general symp- 
toms, the temperature rises to 104° or 106° Fahr. (40° or 41° C), and 
exhaustion is pronounced. Other, less characteristic, symptoms, such as 
grinding of the teeth and mastication without food being present in 
the mouth may accompany the above and arouse fears of peritonitis. 
In sheep the dulness and prostration show^n at first suggest the existence 
of anthrax — a view strengthened by the fact that the respiration becomes 
very frequent and the fever intense, whilst death may be rapid, and may 
sometimes occur with startling suddenness. 

Lesions. Bacteriological examination, or even a naked-eye examina- 
tion, made immediately after death enables one easily to differentiate 
between the two conditions. When the animals have died very rapidly — 
in one night' — lesions of enteritis alone are present. More marked cases 
exhibit thickening and intense congestion of the mucous membrane of 
the abomasum, which may be of a deep mahogany colour. 

The intestine itself is affected, and even though the glandular 
epithelium is little changed, the intercellular sj^aces show ecchymoses 
and multiple hsemorrhages, which give the contents of the digestive 
tract the appearance of wine lees. 

The abdominal viscera scarcely present any characteristic lesions. 
The liver has the appearance of having been boiled, as in many forms 
of .poisoning. The kidney is congested and blackish ; the spleen only 
appears hypertrophied when post-mortem examination has been delayed 
and micro-organisms from the intestine have invaded the circulatory sys- 
tem. After death the kidneys and spleen very rapidly undergo softening. 

Nervous form : Symptoms. Whilst in the first form the symptoms 
appear especially due to diastatic ferments present in the pulp liquid, 
in the nervous form they appear rather to result from the convulsing 
and paralysing action of ptomaines. 

The ox seems more particularly susceptible to the action of the latter. 
It shows symptoms resembling those of horses suffering from a severe 
abdominal form of influenza : profound depression, mahogany- coloured 
conjunctiva, lachrymation, infiltration of the cornea, high temperature 
(104° to 106° Fahr.— 41° to 41-5° C), strong action of the heart, but 
small pulse. The cerebral symptoms are especially marked. The animal 
suffers from vertigo, and when excited, or when attempts are made to 
administer medicine, it thrusts its head against the wall, as though 



DISEASES PRODUCED BY DISTILLERY AND SUGAR FACTORY PULP. 261 

suffering from a cerebral tumour. It also shows liypercnesthesia, slight 
colic, and sensitiveness of the abdomen. 

In sheep the symptoms consist in alternate extreme depression and 
extreme excitability. 

In both species the termination is always rapid : death occurs in a 
few days. 

The abdominal lesions are identical with those of the acute form. 
They consist in gastro-enteritis, or, rather, intense congestion of the 
abomasum and intestine, with extravasation of blood around the acini 
of the glands and beneath the mucous membrane, etc., and in more or 
less marked desquamation of epithelium. 

The annexed organs sometimes present secondary changes : in the 
nervous centres the lesions are more marked ; the meninges are con- 
gested, in some cases inflamed, and cerebro- spinal fluid is present in 
increased quantity. 

Subacute or Chronic form : Symptoms. This form is equally 
frequent in the ox and sheep ; it develops insidiously^ and for a time 
may escape detection. 

The symptoms are those of slight gastro-enteritis without tympa- 
nites; but this condition is succeeded by serous, foetid, uncontrollable 
diarrhoea, which weakens the animal and causes death from excessive 
wasting and hj^draemia. 

The sensitiveness of the entire right side of the abdomen, the special 
diarrhoea, the cardiac disturbance, and the widely- distributed oedema, 
usually suffice to prevent confusion with the ordinary forms of gastro- 
enteritis. In sheep the diarrhoea is blackish, sometimes blood-stained, 
and is accompanied by a sub-icteric or icteric tint of the mucous mem- 
branes, of the skin, and of all the tissues. The intensity of coloration 
affords a guide to the rapidity of development of the disease. The urine 
is also bile- stained, and there appears to be an exchange of functions 
between the two great depurative organs, the liver and kidne3^ '-^^^^ 
urine may become sanguinolent, because it contains either unchanged 
blood or simply dissolved haemoglobin. 

The lesions are similar to those previously described, but with 
modifications of intensity. When diarrhoea has been marked and per- 
sistent, the digestive mucous membrane is hardened, indurated, and 
appears as though tanned. This is due to chronic inflammation, 
probably to the gastro-enteritis with which the condition begins. The 
liver appears as if cooked ; the fat, the majority of the tissues, and 
especially the conjunctiva, exhibit a light yellow tint, pointing to hepatic 
disturbance. 

The diagnosis is generally easy in all three forms, provided that 
the food be examined^ 



262 POISONING. 

The prognosis varies ; the acute and nervous forms are usually 
fatal. But when the disease develops slowly, recovery may occur. 

Pathogeny. Practical observation and laboratory researches show 
that the above conditions result from poisoning. Histological examina- 
tion of livers from sheep which have died rapidly shows complete 
degeneration of the hepatic cells, which become incapable of per- 
forming their function. The biliary acids, no longer being withdrawn 
from the circulating blood, produce general intoxication, destruction of 
the blood corpuscles, and the appearance of hsemaphgeic icterus and 
hsemogiobinuria. 

Treatment. Being convinced that acidity alone caused this disease, 
the older practitioners suggested the administration of salines. In 
reality it is necessary to check fermentation. Drainage of the silos in 
which beet pulp is stored is often sufficient for this purpose ; but if badly 
arranged, drainage rather assists the growth of moulds and various 
organisms in the mass, which affords a medium favourable to their 
multiplication. Complete desiccation would undoubtedly give much 
better results, but cannot economically be effected. The best practical 
measure consists in storing the pulp in special silos, divided into 
compartments by lattice work partitions. The escape of liquid is 
facilitated by forming the floors of the silo with a sufficient slope. 
Preservation, however, is not perfect, and some compartments are 
always found damaged. Excessive fermentation can be checked by 
adding ordinary salt to the pulp in the proportion of '2 per cent. 

Curative treatment comprises restricted diet for several days, and the 
administration of milk, carbonate of soda, and stimulants, which favour 
excretion of the toxins. Some patients may be saved by subcutaneous 
injections of large quantities of normal salt solution. When poisoning 
is pronounced, and the viscera are clearly injured, it is more economical 
to slaughter the animals, provided that the icterus does not render the 
flesh useless for sale. 



CHAPTER VIII. 

PARASITES OF THE DIGESTIVE APPARATUS* 

Pakasites of the digestive apparatus are extremely common in 
ruminants, some, like the infusoria of the rumen, being of no importance, 
others, on the contrary, appearing to play a predominating part in the 
development of certain forms of anaemia and serious wasting diseases, 
such as the various forms of gastro-intestinal strongylosis, coccidial 
enteritis, etc. 

GASTROINTESTINAL STRONGYLOSIS IN SHEEP, 

PARASITIC GASTRO-ENTERITIS. OVINE PASTEURELLOSIS. 

Verminous diseases of the abomasum are common in the sheep and 
goat, but (in France at least) appear rare in the ox. 

Causation. Gastro-intestinal strongylosis is produced by various 
parasites of the genus Strongylus, such as Stvoncnjlus contortus, 
Strongylus convolutus, Strongylus instahilis, Stroiigylus circumcinctus, 
Strongylus filkolis, which occur not only in the abomasum, but also 
in the small portions of the first intestine, sometimes in very large 
numbers. 

The first is a threadlike worm, pointed at both extremities, and from 
^ to 1 inch in length. It exhibits a red tint, which zoologists refer to the 
presence of blood in its digestive apparatus, derived from the host's in- 
testinal mucous membrane. Some doubt has been thrown on the nature 
of this coloration, however ; and certain Italian authors, in common 
with Lignieres, have declared it due to a certain red pigment developed 
in the tissues of the parasite, the spectroscopic reaction of which differs 
from that of haemoglobin. 

The strongyles are said not to penetrate the mucous membrane, but 
simply live on the intestinal contents. This may be true of certain 
varieties, but it is none the less certain that others penetrate the mucous 
membrane deeply, even to the extent of becoming half-embedded in it. 
Particularly is this the case with Strongylus circumcinctus, found in the 
epizooty which occurred at Grignon, and also found by Moussu in grave 
epizootics which he has from time to time investigated. 

According to Lignieres this gastro-intestinal strongylosis only plays a 



264 PARASITES OF THE DIGESTIVE APPARATUS. 

trifling part in the development of the above-mentioned disease, which 
he declares to be due to infection with a cocco-bacillus of the Pas- 
teurella group, the development of which alone, he states, explains 
all the symptoms. 

In France the disease now under consideration has never extended 
beyond limited regions, but in Argentina, where Lignieres carried out his 
investigations, it is said to be very fatal. Lignieres bases his opinion on 
the following facts : — 

Firstly, that experimental verminous infection of young animals does 
not produce either anaemia or cachexia. 

Secondly, that animals in excellent condition may prove to be infested 
with large numbers of parasites. 

Thirdly, that animals which have succumbed to this disease, hitherto 
regarded as verminous, sometimes prove to harbour few or no parasites. 

Fourthly, that this grave and fatal disease, and the symptoms by 
which it is clinically recognised, can be produced with cultures of the 
cocco-bacillus, which he has isolated. 

These statements are very precise, but Mossu declares that he has 
never yet been convinced of the reliability of the last statement referring 
to experimental transmission, any more than of the data regarding 
alleged protective vaccination. 

The symptoms of gastro-intestinal strongylosis or ovine pasteurel- 
losis point to a progressive pernicious anaemia of chronic or subacute 
form. Eapidly progressive cases are exceptional. 

In France the form seen is almost invariably chronic. The animals 
appear dull, sluggish, and feeble ; they lose appetite, waste, become 
anaemic, then cachectic, and, after several months, die of exhaustion 
and wasting, after having shown diarrhoea during the later stages. 

The faeces are pasty, and exhale a very marked putrefactive odour. 
There is little room to doubt that auto-intoxication from resorption of 
intestinal products is continually going on. 

The animal's general appearance is bad, the ears are pendant, the 
wool is dry and dull, and can be removed in handfuls by the slightest 
pull. There are no other external symptoms, and the diagnosis can only 
be arrived at by discovering the eggs of the parasite in the faeces. 

Lesions. Post-mortem examination reveals all the general lesions 
of advanced cachexia and of gastro-enteritis of varying intensity. The 
abomasum and first portions of the small intestine usually contain a 
considerable number of strongyles ; taeniae are often present in the 
intestine, and Moussu declares that he has always found a certain 
number of hooked worms and oesophagostomes. 

The peritoneal, pleuritic, and pericardial exudates common in most 
wasting conditions are always present, but the quantity of exudate in 



GASTRO-INTESTINAL STRONGYLOSIS IN SHEEP. 



265 



each cavity varies within wide Kmits. The liquid ma}^ even resemble 
that due to inflammation or infection ; sometimes it is light pink or 
red in colour. 

Pulmonar}- lesions usually exist. Moussu has almost always found 
gastric strongylosis associated with pulmonary or tracheo-bronchic 
strongylosis, but Lignieres asserts that the Argentine cases showed 
nodules of hepatisation which had nothing to do with the pulmonary 
strongylosis, and which appeared to result from areas of pneumonia 
produced by the specific cocco-bacillus and other organisms. He has 
even found abscesses and cavernous spaces in the lung. 

Pathogeny. According to Lignieres the specific agent of pernicious 
anaetuia is a cocco-bacillus which stains well with fuchsin, violet, blue, 
safranin, etc., but does not 
take Gram, and which in p 
cultures assumes either 
the streiDto-bacillary form 
or occurs in barrel- shaped 
masses. It grows in simple 
bouillon at 38° C, but 
better still in peptonised 
bouillon, w^hich turns tur- 
bid for five or six days, 
afterwards becoming lim- 
23id in consequence of the 
organisms falling to the 
bottom of the vessel. It 
does not coagulate milk. 
On agar the culture is 
thin, bluish, shows an 
iridescent reflection, and 
when old appears whitish. 
Grown on gelatine, the appearances are similar— the gelatine is not 
liquefied ; on serum the pelHcle is scarcely visible. 

The organism is said to be pathogenic for guinea-pigs, rabbits, dogs, 
and, of course, for sheep. Moussu, however, does not consider that the 
reported cases of transmission through the blood stream or by subcu- 
taneous injection are really convincing or characteristic. He does not 
question the fact that Lignieres discovered a special pathogenic agent in 
all cases and in all his patients ; but what appears to him debatable 
is the exclusive part which Lignieres attributes to that agent. 

The fact that in Argentina, just as in France, strongyles have always 
been discovered in epizootics of this nature of itself constitutes some- 
thing; and causes the second fact, that it has never yet been proved 




Fig. 114. 



-Wasting due to gastro-intestinal 
strongylosis. 



266 PARASITES OF THE DIGESTIVE APPARATUS. 

that any heavy mortahty occurred m the absence of parasitic infestation, 
to assume considerable importance. Moussu regards these two facts as 
the greatest obstacles to Lignieres' theory. He states that in his view 
the verminous affection is the essential, primordial and primitive 
affection, and that microbic infection is only secondary, and an almost 
inevitable result of grave verminous infestation. 

It is quite certainly wrong to think that verminous affections may 
continue with scarcely any injury to the animal, especially when such a 
belief is based on observation of a few parasites which are not of a pre- 
datory character. In most cases of the kind now under consideration, 
the various parasites found {Strongijlus circumcinctus and filicolis, Ancliy- 
lostomes, etc.) cause more or less grave lesions. • 

These intestinal wounds facilitate the infection to which the fatal 
course of the disease is due. The disease, then, is not a special unvarying 
infection, but consists of multiple superposed infections. 

It is wrong to believe and to teach that the parasitic disease is of 
no importance, and Moussu declares his belief that the proposed vacci- 
nations will prove unavailing. He is of opinion, on the other hand, 
that when the parasitic invasion can be overcome the mortality Avill 
be checked, and only those animals which are already suffering from 
severe infections will succumb. Is not this precisely what has been 
observed in human pathology regarding miners' anaemia or miners' 
worm disease (anchylostomiasis) ? 

The diagnosis presents no difficulty for those who have had a little 
practice with the microscope, since the presence of eggs of the parasite 
can always be detected in the faeces in cases w'here external signs have 
given rise to suspicion of gastro-entestinal strongylosis. 

The macroscopic diagnosis on post-mortem examination is not so easy 
as might be supposed, and when very small varieties are in question it is 
sometimes necessary to examine the mucous membrane of the abomasum 
or intestine very carefully in order to discover the parasite. 

The prognosis is grave, because before attention has been drawn to 
many patients, the entire herd may be more or less infested. It is also 
grave because the pastures are infested with eggs or embryos, and the 
power of increase of these parasites is enormous. 

Treatment. The earliest and most energetic means should be 
adopted in all cases. Treatment comprises : — 

Drainage of sw^amjoy pastures. 

Dressing of the pastures with chemical manures, preferably with 
iron sulphate, at the rate of 40 to 80 lbs. per acre. 

Disinfection of manure to destroy the contained eggs or embryos. 

The use of chalk, iron sulphate, various acids, etc. 

As regards curative treatment, the diseased animals should be grouped 



LUMBRICOSIS OF CALVES. 267 

and isolated as far as possible, and should receive doses of the following 
vermifuge :— 

Powdered areca nut . . . . . . . . . . . . 2 ounces. 

Arsenic . . . . . . . . . . . . . 30 grains. 

The above is sufficient for ten animals, and a dose should be given 
daily for a period of six days in a small quantity of bran. Treatment 
is completed by abundant nourishment, and by distributing about the 
pastures pieces of rock-salt suitably protected. 

Many other vermicides or vermifuges have been suggested, but are 
less easy to use. They comprise essence of turpentine, mixtures of 
oil with essence of turpentine and benzine, picrate of potash in doses 
of 7 to 20 grains per day, ethereal extract of male fern, etc. 

LUMBRICOSIS OF CALVES. 

^ Following the example of human medicine, w^e apply the term 
'' lumbricosis " to a disease caused by ascarides in calves, although 
Neumann separates the ascarides of calves from the lumbricoid ascarides 
with which they are usually confused in current practice. 

Causation. The disease is exclusively due to infestation with embryos 
of the parasite, wiiich in young calves afterw^ards develop in the first 
portions of the intestine and in the abomasum, interfering with secretion, 
and producing mechanical disturbance, colic, and digestive irregularity, 
eventually follow^ed by marked loss of condition. Death may even follow, 
either from rupture of the pylorus or duodenum, or from secondary 
septicaemia of intestinal origin, due to the parasites burrowing into the 
mucous membrane and facilitating infection. In adults of all species 
lumbricosis is rare. It occurs principally in young animals from the 
time of w^eaning up to the age of eighteen months or two years. 

The diagnosis cannot usually be formed until the parasites are 
found in the faeces, but microscopic examination sometimes reveals the 
presence of the eggs, and thus excites suspicion. 

Provided the condition is diagnosed early, the prognosis is not 
grave ; but when patients have become exhausted and anaemic they re- 
quire a long time to recover, even when freed from parasites. 

Treatment. Guittard recommends empyreumatic oil as very effica- 
cious, and gives it in doses of 2| to 3 drachms diluted with ordinary oil, 
or emulsified with any kind of mucilage. 

Calomel gives good results, and may be administered in doses of 15 to 
60 grains, according to the animal's age and size. 

Pow^dered areca nut would probably be easier to administer wdth the 
food. Oil of turpentine is given mixed wdth ordinary oil, but its action 
is less certain. 



268 PARASITES OF THE DIGESTIVE APPARATUS. 



STRONGYLOSIS OF THE ABOMASUM IN THE OX. 

Although well studied by Stadelmann and Ostertag in Germany, and 
by Stiles in America, this disease has not yet been regarded in France as 
giving rise to accidents. 

It is produced by the Stronr/ylus convolutus rel Ostertagi, which 
becomes embedded under the epithelium of the mucous membrane and 
causes the formation of small nodules, the size of a pin's head or lentil, 
which can be detected on palpation. The cavity thus formed beneath 
the epithelium communicates with the gastric cavity by a little orifice, 
through which the cephalic end of the parasite passes. 

PARASITIC GASTRO-ENTERITIS, DIARRHCEA, AND ANEMIA 
IN CATTLE, SHEEP AND LAMBS. 

A disease characterised by ansemia with wasting and diarrhoea is 
sometimes produced in cattle by the presence in the fourth stomach 
of small strongyles varying in size between 3 and 9 millimetres in length, 
according to the variety encountered. One variety of the smaller size 
has been named by McFadyean Strongylus gracilis. Penberthy, who 
described the disease in the Jour, of Comj:). Path, and Therap. for 1894, 
p. 249, states that in certain cases he also found the Strongylus ventri- 
cosus, the Tricocephalns affiinis, and minute straight worms about ^g- of 
an inch long, which he regarded as anguillulae. Neumann declares 
that pernicious anaemia with catarrh of the abomasum in young animals 
is due to Strongylus convolutus. 

The symptoms comprise anaemia, wasting, and diarrhoea of varying 
severity. In acute cases, which are common between the ages of six 
months and two years, husk is sometimes (accidentally) present. The 
disease is rarest in summer. Certain animals lose flesh rapidly, though 
appetite is retained. Acute foetid watery diarrhoea follows. The animal 
shows tenesmus, appears dejected, and has a temperature of 103° to 
105° Fahr. The mucous membranes become pale, the pulse small and 
weak, the appetite capricious, the eyes sunken, belly tucked up, coat harsh 
and dry and hide tight. Wasting is rapid. The animals are listless, and 
often lie down for long periods. Death occurs from exhaustion. 

The parasite. Scrapings from the abomasum and intestine when 
diluted with water and viewed under a lens show minute bodies re- 
sembling short, fine hairs. When isolated these are easily visible with 
the naked eye. In situ they appear to be lying on the mucous mem- 
brane, sometimes with the head fixed in the latter. They vary in length 
from 2^5 to 2% of an inch, and are brownish in colour. For a detailed 
description see Penberthy loc. cit. McFadyean {Jour, of Comp. Path, and 



PARASITIC GASTRO-ENTERITIS, ETC., IN CATTLE, SHEEP AND LAMBS. 269 



Therap. for 1896, p. 314) also gives a very full description, illustrated by 
plates, of the two species of strongyles which he regards as the cause 
of gastritis in cattle in England. 

The lesions are those of wasting diseases. The first three gastric 
compartments may be thin, but usually show no abnormality. The 
mucous membrane of the abomasum shows evidences of catarrh, is 
sometimes covered with a loose croupous material, or is denuded of its 
epithelium and even extensively destroyed. In acute cases it is more 
or less deei^ly reddened over spots or extensive patches. Occasionally 
it ap23ears jelly-like, owing to effusion into its substance. Except for 
the catarrhal condition 
the small intestines may 
be healthy, but the large, 
especially the colon and 
csecum, show lesions simi- 
lar to, but more pro- 
nounced than, those of 
the abomasum. 

The treatment com- 
prises administration of 
the usual vermifuges, of 
which Penberthy prefers 
turpentine. The diet 
should be nutritious and 
easily digestible. Among 
drugs, non - irritant iron 
salts, cod liver oil, bitter 
vegetable tonics and com- 
mon salt are recom- 
mended. The animals should be housed and kept warm ; the litter, 
containing parasites, should be destroyed. The pastures may be dressed 
with salt and lime ; those worst infected should be ploughed. An un- 
infected water supply is essential. 

Parasitic Gastro-enteritis in Sheep and Lambs. A disease in seven 
to eight months old lambs, closely resembling the above, was described 
by McFadyean in the Jour, of Corny. Path, and Therap. for 1897, p. 48. 
Sheep over one year old were not affected. 

The symptoms comprised diarrhoea, rapid wasting, impaired appetite, 
thirst, a tendency to lick and sw^allow sand or earth, dulness, and con- 
tinued fever (105° to 108° Fahr.). There was no evidence of acute pain 
or of marked cough. 

Duration. The disease sometimes proved fatal in one or two days, 
but sometimes extended over several days or w^eeks. The mortality 




Fig. 115. — Caudal extremit}^ of male Strongylus ce?'- 
vicornis. (Block kindly lent by Prof. McFadyean.] 



270 



PARASITES OF THE DIGESTIVE APPARATUS. 



varied from 10 to 20 per cent., but in many cases almost all the 
members of a flock exhibited diarrhoea and loss of condition. 

The cause appeared to be the presence of small nematode worms in 
the fom'th stomach, which generally exhibited gastritis with inflammatory 
congestion of the mucous membrane, though in a considerable number 
of cases the lining membrane of the stomach was markedly anaemic. In 
a large number of cases the irritation of the mucous membrane was 
continued into the duodenum, but as a rule the remainder of the small 
intestine was not inflamed. 

The worms named by McFadyean Strongylus cervicornis are from 10 

to 12 mm. in length, so that although not of microscopic dimensions 

they cannot be seen when suspended in the stomach contents. They 

are readily detected in microscopical preparations under a low power. 

The treatment is similar to that of gastro-enteritis in cattle, but chief 

attention should be directed to 
prophylaxis. 

^ * * * 

A verminous disease, closely 
simulating the above, and 
affecting cattle, sheep, and 
goats in Texas, is described 
by Ch. Warden Stiles in the 
Annual Eeport of the United 
States Department of Agricul- 
ture for 1900, p. 356. The 
disease was of mixed character, 
and consisted in various de- 
grees of verminous gastritis, 
verminous enteritis, and ver- 
minous bronchitis. In the 
stomach were found the common twisted wireworm {Strongylus contortus) 
and Ostertag's encysted wireworm {Strongylus Ostertagi). It appeared to 
be present in every calf, steer and cow examined (post-mortem), and was 
undoubtedly the chief agent in causing death. The sheep and goats 
were very similarly affected. In the bowel of cattle were found the 
hookworm {Uncinaiia radiata), nodular disease w^orm {(Esopliagostoma 
colunihianum) : in that of sheep the hookworm {Uncinaria cernua) and 
nodular disease worm {G^soj^h ago stoma columhiamnn) , and the fringed 
tapeworm {Thysanosoina act'niioides). In the lungs of the cattle Stron- 
gylus micrurus (the small-tailed lungworm), and of sheep the thread- 
worm strongyle {Strongylus filaria) were detected. 

Treatment. Sulphate of copper, gasoline and coal-tar creosote 
were tried, but the best results were obtained from doses of 30 grains 




Fig. 116. — Caudal extremity of male Stron- 
gylus contortus. (Block kindly lent by Prof. 
McFadyean.) 



INTESTINAL COCCIDIOSIS OF CALVES AND LAMBS. 271 

(for a lamb) up to 100 grains (for a two-year-old sheep) of thymol in 
1 per cent, coal-tar creosote solution. 

INTESTINAL COCCIDIOSIS OF CALVES AND LAMBS (PSORO- 
SPERMOSIS, H/EMORRHAGIC ENTERITIS, BLOODY FLUX, 
DYSENTERY, ETC). 

History. This disease is very common in the Avalon and surrounding 
districts, sometimes assumes the characteristics of a true epizootic, and 
affects young bovine animals between the ages of six months and two 
years, but is commonest and most contagious in animals of from ten to 
eighteen months old. 

It attacks animals in good or bad condition, without distinction of 
breed or species. It begins towards the end of July, attains its maximum 
development towards the end of August and September, and dis- 
appears in October, though occasionally it continues until November. 
In exceptional cases Degoix has seen it during January and February in 
animals which had returned from the fields to the byres about the end 
of November. It develops earlier than verminous bronchitis, in con- 
junction with which, however, it often occurs. It is commonest in warm, 
moist, rainy years, and amongst animals pastured on swampy ground 
containing numerous springs and streams. Year after year it attacks 
animals occupying particular pastures in summer. The soil of these 
pastures is undoubtedly infested with the germs of the disease, just as 
in places the soil is infested with anthrax bacilli. The appearance of 
symptoms is preceded by an incubation period of one or two months. 
The length of this incubation period is fixed by the observations which 
Degoix has made during the past tw^enty years, and depends on the time 
which elapses between the animals being turned into infected pastures 
and the appearance of the preliminary symptoms. 

Symptoms. The disease commences with liquid, serous, foetid, 
greenish-black diarrhoea, the material being voided without special strain- 
ing and the animals losing neither their spirits nor appetite. Fever can 
scarcely be detected, the temperature ranging between 38° and 39° C. 
On the second or third day the diarrhoea changes in character. Though 
it always remains foetid, it now becomes mucous, reddish-black, or 
sanguinolent, and contains more or less frequent blood clots of varying 
size. 

The passage of this material causes violent straining, which becomes 
more and more common, and is accompanied by very pronounced rectal 
tenesmus. The animals stand with their backs arched for one or two 
minutes, sometimes longer, and the liquid escapes in large quantities, 
soiling the quarters and hocks. The animals are dull, show a certain 



272 PARASITES OF THE DIGESTIVE APPARATUS. 

degree of colic, and frequently grind the teeth. Appetite is lost, thirst is 
severe, and rumination ceases. Wasting makes rapid strides, the coat 
stares, the animals have difficulty in standing on account of their weak- 
ness, fever sets in, and the temperature rises to 40° C. This condition 
may last from five to ten days and terminate either in recovery or death. 
Kecovery is frequently rapid in animals which have continued to eat, and 
in which the acute period has heen of short duration — five to seven days 
at most. On the other hand, it is slow if the appetite has disappeared 
and the acute period has been prolonged beyond ten days. 

The diarrhoea, which has lost its sanguinolent character towards the 
sixth or eighth day, may continue for somewhat longer. The attacks of 
straining become rare, and cease between the tenth and fifteenth days. 
The appetite remains capricious for a long time. 

Convalescence is marked by alternate improvement and retrogression. 
The animals are weak, and only recover quickly under energetic treatment 
and forced feeding with concentrated digestible foods like milk, soup, 
cooked grain, etc., administered for three w^eeks or more. 

Death may occur towards the tenth or fifteenth day from exhaustion. 
The patients become very anaemic and thin, the eyes are w^ithdrawn into 
the orbits, and the animals appear indifferent to what goes on about 
thjem. They still groan feebly, occasionally grind the teeth, and lie con- 
tinually on the chest with the head extended. The body temperature 
falls and death follows. 

In well-bred animals in good condition the disease sometimes assumes 
a much graver and more rapidly progressive form, with peracute symp- 
toms, and makes as many, if not more, victims than that previously 
described. 

The process is as follows : After suffering for a day from serous 
diarrhoea, to which the owners pay little attention, the animals show 
sanguinolent diarrhoea and pass blood clots. This is almost immediately 
followed by very violent convulsive attacks — true eclampsia. The 
animals are then unable to stand, lie on the side with the head 
outstretched and resting on the ground, the eyes withdrawn into the 
sockets and often showing pirouetting movements (nystagmus), the neck 
drawn upw^ards and backw^ards (opisthotonos), and the limbs rigidly 
extended. From time to time the wiiole body is shaken by extremely 
violent convulsive movements. 

This condition, which is sometimes preceded by weakness of the hind 
quarters and symptoms of locomotor ataxia and inco- ordination, may con- 
tinue from six to thirty-six hours ; in nine cases out of ten it terminates 
in death. 

Causation. On microscopic examination of the serous dejections 
one finds distributed throughout the liquid mass very small numbers of 



INTESTINAL COCCIDIOSIS OF CALVES AND LAMBS. 273 

ovoid corpuscles having a double outline, and contents of varied 
a]3pearance ; these are the coccidia. 

When the diarrhoea has become sanguinolent and muco-fibrinous, the 
fluid contains these coccidia in considerable quantities, and large numbers 
of them may be found in the mucus, where they are mixed with epithelial 
debris, blood corpuscles, and lymphatic cells, etc. They are rarer in the 
clots. Coccidia cannot be found in the faeces of healthy animals, even in 
those occupying the same pastures with the diseased. Should the clinical 
symptoms be thought insufficient of themselves clearly to identify the 
disease, a simple microscopic examination of the faeces will remove any 
doubt. 

Lesions. Post-mortem examination immediately after death enables 
one exactly to identify the habitat of the parasite and the lesions it pro- 
duces. These lesions are to be found throughout the large intestine, 
from the caecum to the anus. 

The large intestine is almost or entirely empty, the mucous membrane 
is reddish-brown in colour, lies in folds, is oedematous, and everywhere 
covered with a coating of mucus. This coating varies in character at 
different points ; in places it forms more or less thickened patches of 
greyish or yellowish colour, and of a resistant character, as though mixed 
with coagulated fibrin. These patches are fairly well defined, they are 
irregular in form, and vary in width from some millimetres up to several 
centimetres. They are more or less adherent to the mucous membrane, 
from which they can easily be stripped away. The mucous membrane 
thus exposed is slightly depressed, and of a whitish colour, thus markedly 
contrasting with the surrounding red coloration. This depression repre- 
sents a slight ulceration, which, though superficial, is clearly visible to 
the naked eye. 

Microscopic examination of the mucus patches reveals the existence, 
both superficially and in the depths, of epithelial cells derived from the 
mucous membrane, of vesicular cells derived from the Lieberkuhnian 
follicles, of numerous blood and lymphatic corpuscles, and, distributed 
irregularly throughout this mass of cells, of coccidia, resembling those 
found in the dejections. 

In thin sections of the intestine, made through the ulcerated mucus- 
covered patches, and in a direction perpendicular to the mucous 
membrane, one finds that the epithehal covering of the intestine has 
disappeared. 

The Lieberkuhn's follicles are shortened, their orifices are irregular 
and partly blocked with epithelial debris. In a large number of these 
follicles the blind extremity is dilated, and more or less filled with coccidia, 
varying in appearance according to their stage of development. The 
epithelial cells normally lining these blind ends seem to have disappeared, 
D.c. T 



274 PARASITES OF THE DIGESTIVE APPARATUS. 

and to have been replaced by the parasites. This, however, is not really 
the case. It is easy to prove by suitable dissection (after maceration of 
the sections in 30 per cent, alcohol) that the coccidia are lodged in epithe- 
lial cells which have become modified in shape and undergone hypertrophy 
as the parasite has grown, whilst the nucleus has been pushed to one end 
and undergone atrophy. 

Alongside the deceased glands may be found others which are quite 
healthy. In the parts which are most markedly affected the interglan- 
dular connective tissue is infiltrated and slightly thickened. Degoix has 
never discovered coccidia in the cells of the intestinal mucous membrane 
itself. The lesions may be met with throughout the large intestine, but 
are more numerous and grave as the rectum is approached. 

This disease is characterised by extensive inflammation, affecting the 
entire mucous membrane of the large intestine, by more or less extensive 
ulceration of this bowel, the ulcers being covered with muco-fibrinous 
patches rich in coccidia, by localisation of the parasites in the epithelial 
cells of the glandular cul-de-sac, by the appearance of the disease at a 
special time of year and in special districts, where it assumes the form 
of an enzooty, and by the fact that it always appears in the same pastures. 
The mortality varies between 12 and 25 per cent, from year to year. 

Microscopic appearances. The protozoa which produce this disease 
assume the form of ovoid cysts, varying in length from 18 to 25 /x, and 
measuring at the widest part about 13 /x. They possess a hyaline envelope 
whose existence is proved by its double contour line, and yellowish, 
granular, highly refractile contents. This granular material does not 
always occupy the whole of the cavity. At a certain stage of develop- 
ment it collects towards the centre, forming a nucleus and leaving clear 
spaces at the poles of the cell. At a later stage this nucleus divides into 
four portions which afterwards separate. 

Treatment. The protozoa, in their cystic condition, are very resistant 
to destructive influences. The most common natural cause of their de- 
struction is drying in the open air. Unfortunately, in the localities where 
the patients usually live, that is, filthy byres, wet. pasturages, etc., this 
destruction only takes place to a very limited extent. 

The disease can be attacked by prophylactic and therapeutic measures. 

Prophylaxis consists — firstly, in destroying the parasites contained in 
the dejections by the free use of 3 per cent, sulphuric acid solution ; and, 
secondly, in removing the young animals from infected fields during the 
months between June and September. 

Therapeutic treatment comprises — firstly, stimulant applications 
to the abdomen ; secondly, disinfection of the intestine by the adminis- 
tration of salol, benzo-naphthol, very diluted solutions of creolin, etc ; 
thirdly, intestinal irrigation by the administration of mucilaginous drinks 



INTESTINAL HELMINTHIASIS IN RUMINANTS. 275 

containing bicarbonate of soda, supplemented by general tonic treatment 

and the supply of concentrated, very nourishing, and easily digested food 

(Degoix, Revue generale de Medecine Veterinaire, No. 28, February 15th, 

1904, p. 177). 

***** 

McFadyean describes a similar disease to the above in two to three 
months old lambs {Jour, of Comp. Path, and Therap., March, 1896, p. 31). 
The mortality reached 10 per cent. The lambs at the time the disease 
broke out in the flock were closely folded together with the ewes on 
growing roots, which, needless to say, were much soiled with earth and 
faeces before they were completely consumed. 

INTESTINAL HELMINTHIASIS IN RUMINANTS 
(Ox^ Sheep^ Goat). 

Verminous disease of the intestine is often accompanied by similar 
disease of the stomach (gastro-intestinal strongylosis of the sheep, lum- 
bricosis of the calf), but it also occurs apart from the 
presence of gastric parasites. Parasites are more 
frequent in the intestine than in the abomasum, 
because the alkaline intestinal juices prove a much 
more favourable medium for their development than 
do the acid juices of the stomach. 

The actual parasites may include ascarides, stron- 
gyles, hooked w^orms, oesophagostomes, tricocephales, 
sclerostomes, and various taeniae {Tcenia expansa ct 

alha). Many of these have already been, or will here- 

p, 1 -I ; Fig. 117. — Head of 

after be, referred to. ^ . „ , ^, 

__,.,...-, . T ,., . Tcenia alba or the 

Helmmthiasis due to round worms like stron- ^^^^.a sheep. (After 
gyles, and the various forms of hooked worm, is Neumann.) 
graver than that due to flat worms, but most extra- 
ordinarily varied collections are sometimes met with. Speaking gene- 
rally, however, helminthiasis more particularly affects young animals 
like calves, lambs, and yearling sheep, is rarer in adults, and in all cases 
the complications it produces are of trifling importance in adults as com- 
pared with those caused in the young. 

The persistence of verminous diseases in certain infested countries, 
districts, farms, or pastures is explained by the enormous number of eggs 
or embryos passed with the faeces and disseminated with manure, as well 
as by the high degree of resistance of the eggs and embryos to destructive 
influences. 

Causation. The various forms of intestinal helminthiasis are all due 
to embryos or eggs of AYorms obtaining entrance to the stomach or bowels 

T 2 




276 



PARASITES OF THE DIGESTIVE APPARATUS. 



f 



of susceptible animals. Nevertheless, external conditions largely favour 
infestation. The existence of marshes, ponds, and stag- 
nant water on certain pastures, heavy annual rainfall, 
the occurrence of wet seasons, etc., favour the existence 
and growth of embryos, and, as a consequence, the in- 
festation of animals. 

The symptoms of intestinal helminthiasis are always 
very vague, whether the victims be oxen, sheep, or goats. 
They point to the slow and progressive development of 
a pernicious anaemia, characterised primarily by inter- 
ference with appetite and digestion, then by anaemia, 
and finally by cachexia. The patients are dull, lose 
condition, suffer from depraved appetite, and, during 
the cachectic period, from diarrhoea, and die in a con- 
dition of exhaustion. These forms of helminthiasis are 
much more frequent in sheep than in oxen. 

The diagnosis is only arrived at by discovering 
parasites in the faeces, or, in those doubtful cases where 
one has been led to make a microscopic examination 
of the excrement, by the detection of large numbers 
of eggs. 

From an economic standpoint the prognosis is grave, 
because severely infected animals recover their condi- 
tion very slowly, Avhatever treatment be adopted. 

Treatment includes the measures previously indi- 
cated regarding the destruction of germs, eggs, or em- 
bryos distributed over the pastures, and the drainage of 
wet grounds and stagnant pools. Where such diseases 
are common, the pastures should be dressed with iron 
sulphate, and the stable manure disinfected or burned. 

Curative treatment comprises the administration of 
such anthelmintics as can be given with the food. They 
should not require to be administered by force, as this 
proceeding would not only necessitate a great loss of 
time, but might result in accidents. 

Arsenious acid, in doses of 15 grains per day, and 
tartar emetic, in doses of 75 to 150 grains, according to 
the animal's size, are among the best drugs for oxen, and 
may be given for four or five days running. Benzine, 
oil of turpentine, and empyreumatic oil are more diffi- 
cult to administer. 
In the case of sheep, preference should be given to areca nut, 
in doses of 75 to 120 grains, according to the animal's size, and to 



rr 

Fig. 118.— Adult 
specimen of the 
fringed tape- 
worm {Thysa- 
noso7na actini- 
oides). (After 
Stiles, 1893.) 



Intestinal helminthiasis in ruminants. 277 

tansy, which are convenient to give, and can be added to bran, oats, or 
beetroot. 

Adult tapeworms of oxen are of relatively minor importance, but one 
tapeworm of sheep, viz., the fringed tapeworm {Thysanosoma actinioides), 
also known as Tcenia jimhriata ; Moniezia fimhrtata deserves notice. 



Fig. 119. — Ventral and apex views of the head of the frmged tapeworm 
(Thysanosoma actinioides). X 17. (After Stiles, 1893.) 

as at times it forms a veritable scourge to the sheep industry of 
North America and South America. 

Disease. The disease in sheep caused by the fringed tapeworm has 
been studied in detail by Curtice, who considers that next to scab it is 
the most important sheep disease of the western plains of North America. 
The financial loss it causes is extensive, and results from the failure of 
the lambs to fatten, the small crop of w^ool, and the weakening of the 
animals, so that they cannot withstand cold winter weather. The para- 
sites develop slowly, and are present in considerable numbers before their 




Fig. 120. —Segments of the fringed tapeworm {Thysanosoma actinioides), 
showing canals and nerves, and (/) fringed border, {t) testicles, and {ut) 
uterus. Enlarged. (After Stiles, 1893.) 

presence is suspected. Toward September the lambs fail to grow as they 
should ; in November the symptoms are marked. First, the worms pro- 
duce local irritation of the intestine, which finally develops into a chronic 
catarrhal inflammation ; their presence in the gall-ducts produces similar 
results, and obstructs the flow of bile ; infected lambs are large-headed, 
under-sized, and hide-bound ; their gait is rheumatic, and they appear 
more erratic than the other sheep, standing oftener to stamp at the 
sheep-dogs or herds, and lagging behind the flock when driven ; the 



278 I^ARASITES OF THE DIGESTIVE APPARATUS. 

general symptoms are those of malnutrition, and Curtice considers them 
nearly identical with the symptoms of the " loco *' disease ; in fact, he 
states that it is extremely difficult to distinguish between the two diseases, 
and believes that the fact that the worms " may tend to produce depraved 
appetites and a morbid craze for a particular food is also reason for sus- 
pecting that the loco disease may depend on the tapeworm disease." 
General systemic disturbances result from malnutrition ; the usual fat 
is absent ; serous effusions are noticed in the body-cavities, serous infil- 
tration in the connective tissue. 

Treatment is similar to that of parasitic gastro-enteritis of sheep and 
lambs (which see). 



CHAPTER IX. 
DISEASES OF THE LIVER. 

Feom the physiological standpoint the liver is an organ of such im- 
portance that its pathology should be studied as completely as possible. 
Furthermore, it is often the seat of a number of varying lesions, either of 
parasitic, toxic, infectious, or cancerous origin. 

In animals of the bovine species the liver is placed in the right retro- 
diaphragmatic region, so that it is somewhat difficult to examine by any 
of the ordinary methods, like palpation and percussion. Under normal 
conditions it is entirely concealed beneath the hypochondrium, except 
towards the upper margin of the thirteenth rib, where it can be examined 
by palpation. When, as in various morbid conditions, it is considerably 
increased in size, it extends as far as the margin of the hypochondriac 
circle, thus becoming directly accessible to palpation and percussion. 
Sometimes it even enters the hypochondriac region, passing outside the 
omasum and abomasum, which it then thrusts towards the middle of the 
abdominal cavity. 

The margin of the liver exhibits a depression lodging the gall bladder 
nearly opposite the centre of its vertical depth. 

As the liver is so deeply situated, percussion is found to be the method 
of examination which gives the best results. Beyond the limits of the 
zone of auscultation, percussion gives above a semi-dull sound, then, 
proceeding downwards, a dull sound due to the liver, the omasum, and 
the collection of liquid in the bowel. When this dulness is well defined, 
clear, broad from above downwards, and extends to or beyond the hypo- 
chondrium, it indicates hypertrophy of the liver. By deep palpation of 
the posterior margin of the hypochondrium the liver can then be sounded, 
and its excessive size detected. 

The symptomatology of the liver is still very imperfectly understood, 
for in practice the urine is rarely tested for bile pigments, nor attempts 
made to ascertain whether the glycogenic function is normal by the test 
for alimentary glycosuria. 

In this connection nothing has yet been done to assist in diagnosing 
certain hepatic conditions. Fortunately, those diseases of the liver 
which we have to study are more often of a parasitic nature than true 
diseases of the hepatic tissue. 



280 DISEASES OF THE LIVER. 

The reported cases of venous or biliary cirrhosis, moreover, are too ill- 
defined and too incomplete to be taken as a type for description. We 
leave them on one side. In a similar way, apart from parasitic cholan- 
geitis and cholecystitis, inflammations of the biliary ducts are little 
known, and are rare. 

CONGESTION OF THE LIVER. 

In bovine pathology only passive congestion of the liver, often a result 
of Various primary affections with cardiac lesions, is well recognised. 

Active congestions probably occur during infections or intoxica- 
tions of various kinds, but have not been made the object of special 
research. 

Among diseases likely to produce passive congestion must be included 
all those which interfere with the return circulation through the posterior 
vena cava. All cardiac affections with lesions of the valves or orifices of 
the right heart, all forms of pericarditis, tumours or lesions of the 
mediastinum compressing the posterior vena cava, produce stasis, 
passive congestion, and progressive development of what is called 
" cardiac liver." 

Symptoms. The liver is considerably hypertrophied, as a consequence 
of the stasis of blood and progressive dilatation of the portal system. Its 
2one of dulness increases in size, whilst on palpation its borders may 
sometimes be detected. This condition is always accompanied by 
digestive disturbance. 

The function of the liver is more or less interfered with ; the urine is 
scanty in amount and charged with deposit. Ascites of varying intensity 
frequently occurs ; cardiac disturbance accompanies or usually precedes 
the above symptoms. 

The lesions of passive congestion are represented by progressive 
dilatation of the entire portal venous system (nutmeg liver). In time 
this dilatation may produce biliary cirrhosis, as a result of chronic 
irritation of the blood-vessels and perivenous inflammation. This 
condition is known as " cardiac cirrhosis of the liver." 

The diagnosis of this pathological condition is generally easy, provided 
that the primary disease which causes it be recognised. 

The prognosis is always grave, and the practitioner is limited to 
treating the jprimary affection, such as endocarditis, pericarditis, etc. 

NODULAR NECROSING HEPATITIS. 

This form of inflammation of the liver is somewhat rare in animals of 
the bovine species. The disease is diflicult to diagnose, and is often only 
recognised on post-mortem examination. 



NODULAR NECROSING HEPATITIS. 



281 



Isolated tracts of the liver become inflamed, bet\Yeen which the rest of 
the tissue j^reserves its normal character ; the parts affected appear to 
undergo complete degeneration, the cause of which is difficult to 
explain. On examining aff'ected animals after death, the liver is found 
to be greatly enlarged, and apparentl}^ invaded by multiple tumours. On 
section, the parenchyma generally is of normal colour, but the diseased 
jDarts are represented by dirty greyish-yellow tissue of a lardaceous 
character, somewhat resistant to the knife. 

The affected spots vary in size, between that of a lentil or hazel nut 
and an egg, and are formed of necrotic tissue. 

The periphery is the seat of true chronic fibro-plastic inflammation. 

Causation. According to St abbe, these lesions are produced by 
microbes, originating in the intestines, and carried to the liver by the 



f m'V^., 




Fig. 121. — Appearance of the liver in necrosing hepatitis 



mesenteric veins. The lesions and blood of the liver yield cultures of a 
microbe resembling that of necrosis ; nevertheless, such lesions have not 
been experimentally reproduced. 

According to Berndt, infection from the uterus is possible, and indeed 
probable. Moussu has only seen three cases of this particular condition 
of the liver in living animals. Two of these were in a working ox and a 
bull respectively, so that Berndt' s view would not seem to be exclusively 
applicable. Moussu is convinced that infection is of intestinal origin, 
and that it takes place through the mesenteric veins ; he claims to 
have found the proof of this in the existence of multiple pylephlebitis 
and complete obliteration of the subhepatic veins in some cases. 

Symptoms. The symptoms are so vague as to render diagnosis diffi- 
cult. Berndt, on the other hand, regards it as fairly easy. He states 



282 DISEASES OF THE LIVER. 

that the disease occurs in old cows, which after parturition show loss of 
appetite, polydipsia, fever, dyspnoea, and short, feeble cough, suggesting 
pneumonia. After a few days the animals appear extremely weak, 
remain lying for long periods, and exhibit icterus. Percussion of the 
liver detects abnormal sensibility and hy^Dertrophy. 

The three cases seen by Moussu showed only slight yellowness of the 
membranes, general weakness and difficulty in walking, which at first 
glance appeared to suggest laminitis, marked hypertrophy of the liver, 
sensitiveness over the hepatic region, and, as complications, uncontrollable 
diarrhoea and peritonitis.. But these symptoms are also noted in suppu- 
rating echinococcosis, and even in cancer of the biliary ducts, so that 
diagnosis does not appear easy. Nevertheless, there is always marked 
fever, and on post-mortem examination it is not unusual to find, in 
addition to the hepatic lesions, a certain amount of perihepatitis, partial 
peritonitis, and even pleurisy in the region of the diaphragm. The 
question is of little practical importance, for the gravity of the disease 
just described is such that economically no treatment is possible. The 
great point lies in correctly diagnosing disease of the liver, and that is 
relatively easy. 

CANCER OF THE LIVER AND BILE DUCTS. 

Cancer of the liver, that is, broadly speaking, the development in the 
liver of malignant tumours, capable of becoming generalised throughout 
the organism, is comparatively rare when compared with parasitic 
diseases of the same organ. It may be primary or secondary in 
character, but is much more frequently secondary. In bovines primary 
cancer assumes the forms of adenomata, trabecular epitheliomata, or 
adeno-carcinomata. Moussu describes a case in which the growths 
assumed the form of papillomata or adeno-papillomata extending 
throughout the biliary ducts, and partly obstructing the common bile 
duct, which was greatly dilated. 

The real cause of these, as of all other primary tumours, remains 
shrouded in mystery. 

Secondary cancer is more frequent; it occurs usually in the form 
of little isolated tumours (nodular cancer) of varying size and greyish 
colour. 

Symptoms. Clinically the description, or rather the identification, 
of cancers of the liver is difficult, and the diagnosis particularly trouble- 
some in cases of primary cancer. 

In secondary cancer (following tumour of the testicle in oxen castrated 
by the method of bistournage, for example) the general condition, on the 
other hand, is usually so affected that attention is pointedly drawn to the 



ECHINOCOCCOSIS OF THE LIVER. 



283 



seat of the secondary growths. The patients lose appetite, the faeces 
become foetid, and diarrhoea sets in without clear signs of enteritis. 

Examination of the liver always reveals hypertrophy, and sometimes 
sensitiveness. The patients rapidly lose flesh, become cachectic, and the 
proportionate number of red blood corpuscles diminishes. From the 
normal of six or seven millions the number may fall to one milHon or 
less, while that of the white corpuscles considerably increases. This 
leucocytosis, which accompanies all forms of visceral cancer, enables 
one to distinguish between cancer and chronic forms of diarrhoeic enteritis ; 
it must not be confused with leucaemia. Moderately developed ascites is 
common, in consequence of obstruction in the porto-hepatic circulation. 




Fig. 122. — Portion of pig's liver infested with echinoccocus hydatid, natural 
size. (Stiles, Annual Eeport, U.S.A. Department of Agriculture, 1900.) 

The diagnosis of cancer of the liver or biliary ducts is surrounded 
with difficulty, and the prognosis is extremely grave, because no treatment 
is possible. 

ECHINOCOCCOSIS OF THE LIVER. 

This term is applied to the development in the depths of the hepatic 
parenchyma of hydatids of Tceiiia echinococcus. 

The echinococcus hydatid is found in man, cattle, sheep, swine, etc. 
It represents an intermediate stage of development of the echinococcus 
tapeworm of dogs. Since this parasite develops its larval stage in 
man also, and further, since it is the most dangerous animal parasite 
found in man, it is important to thoroughly understand its life history 
in order to guard against infection. 

Adult stage {Tcenia echinococcus) . 



284 



DISEASES OF THE LlVEH. 



Hosts. Dog, dingo, jackal, wolf. 

Life history. Starting with the adult tapeworm (Fig. 124) in the 
small intestine of the dog or wolf, the eggs are scattered over the ground 
and are swallowed by the intermediate host with the fodder or water. 
Upon arriving in the stomach the egg-shell is destroyed, and the six- 




FiG. 123. — Portion of the intestine of a 
dog infested with the adult hj'datid 
tapeworm [Tcenia ecliinococcus, 
natural size. (After Ostertag, 1895.) 



m 




Fig. 125. — Hooks of adult hj^datid tape- 
worm, a, From a hydatid ; 6, three 
weeks after feeding to a dog ; c, from 
an adult ; d, combined figures of a — c, 
showing the gradual changes in form. 
X 600. (After Leuckart, 1880.) 



Fig. 124. — Adult hydatid tapeworm 
{Tcenia ecJdnocoecns) enlarged. 
(After Leuckart, 1880.) 



hooked embryo, which is thus freed, bores its way through the intestinal 
wall, and wanders, actively or passively (that is, carried along by the 
blood), to various organs of the body — liver, lungs, ovaries, bones, skull, 
etc. — where it develops first into an acephalocyst, which may develop 
further, as shown by the accompanying illustrations. The heads which 
are formed, upon being devoured by a dog or. wolf, then develop into 
adult tapeworms. 



ECHINOCOCCOSIS OF THE LIVER. 



285 



Young animals are most exposed to this disease ; in adults or aged 
animals the migration and development of the embryo are more difficult. 




Fig. 126. — Diagram of an echmococciis hydatid, cu, Thick external cuticle ; 
]ja, parenchym (germinal) layer ; c, d, e, development of the heads, 
according to Leiickart ; /, g, h, i, A-, development of the heads accord- 
ing to Moniez ; Z, fully-developed brood capsule with heads ; m, the 
brood capsule has ruptured, and the heads hang into the lumen of 
hydatid ; n, liberated head floating in the hydatid ; o, p, q, r, s, mode of 
formation of secondary exogenous daughter cyst ; t, daughter cyst with 
one endogenous and one exogenous grand-daughter cyst ; 21, v, x, forma- 
tion of endogenous cyst, after Kuhn and Davaine ; y, z, formation of 
endogenous daughter cysts, after Naunyn and Leuckart ; y, at the 
expense of a head, z, from a brood capsule ; evag, constricted portion 
of the mother cyst. (After K. Blanchard, 1886.) 

These embryos perforate the tissue of the liver, become fixed in it, 
and derive from it the nourishment necessary for their conversion into 
cystic bladders of varying size, either sterile or fertile. 

The number of vesicles is rarely large, and ^yhen only one or two are 



286 



DISEASES OF THE LIVER. 




Fig. 127. -A racemose echino- 
coccns, natural size. (After 
Leuckart, 1880.) 



present they seldom produce sufficient disturbance to attract attention. 

On the other hand, when numerous they deform the liver, produce 

glandular atrophy, increase the total size of 
the organ, and lead to the appearance of 
clearly-marked symptoms. 

The cystic vesicles contain a clear, limpid, 
transparent fluid, in which float secondary, 
daughter, or granddaughter vesicles. 

Symptoms. Echinococcosis of the liver 
has no well-marked symptoms, and is there- 
fore difficult to diagnose in animals whose 
liver is deeply seated, and therefore 
beyond palpation. The signs which may 
characterise the period of penetration of the 
embryos through the intestine and into the 
depths of the liver, and which are probably 
represented by slight colic, vague pain and 
diarrhoea, usually pass unnoticed. But later, 
when the liver is extensively invaded ap- 
petite becomes irregular without apparent 
cause, animals show intractable diarrhoea, 

general feebleness, dulness, and wasting. 

These symptoms do not point with sufficient clearness to a special 




Fig. 128. — Section thirough a 
multilocular echinococcus. 
X 30. (After Leuckart, 
1880.) 




Fig. 129.— a multilocular echino- 
coccus from the liver of a steer, 
natural size. (After Ostertag, 
1895.) 




Fig. 130. — A multilocular echino- 
coccus from the pleura of a hog, 
natural size. (After Ostertag, 
1895.) 



ECHINOCOCCOSIS OF THE LIVER. 



287 




Fig. 131. — Echinococcus 
bladder worm or hydatid. 



visceral lesion, but as they call for a complete examination, the prac- 
titioner is almost forced to a certain conclusion by the fact that the 
examination remains negative except in re- 
gard to the liver. The liver seems large and 
sensitive, and may sometimes be considerably 
hyper trophied, for cases have been seen in 
the ox where the normal weight of 10 to 12 
lbs. has been increased to 60 or even 100 lbs., 
while in the pig, whose liver normally weighs 
4 lbs., the weight has been as high as 20 or 
40 lbs. In such cases percussion and pal- 
pation show that the liver extends beyond the 
right hypochondriac region and invades a 
large portion of the corresponding flank. But 
such great enlargement is exceptional, and 
when only a dozen vesicles are present, al- 
though the functions of the liver may be 

seriously disturbed, the information obtained by physical examination 
is seldom sufficient to justify an exact diagnosis. The 
liver is found to be enlarged and thickened; otherwise 
the examination gives negative results. 

The diarrhoea may result from failure of the liver to 
secrete sufficient bile to destroy intestinal toxins, or to 
carry on its gij^cogenic function ; but it may possibly be 
the direct result of chronic intoxication by the contents 
of the vesicles. 

Experience has shown, in fact, that in man, when a 
superficial vesicle becomes ruptured, the peritoneal cavity 
is flooded with the contents of the cyst ; the daughter 
cysts adhere to the peritoneum, and that almost invari- 
ably vascular disturbance occurs, accompanied by itching 
of the skin and an eruption resembling that of urticaria. 
The liquid of the vesicles contains an active tox- 
albumin. 

Diagnosis. In certain cases, diagnosis is possible, and 
even easy, but in others it is extremely difficult and almost 
impossible. 

Prognosis. The prognosis is always grave, for if the 
lesions in the liver do not produce death, as usually 
happens, they so profoundly affect the animals' general 
state, that it is no longer worth while to keep them alive. 
No practical treatment exists. In exceptional cases it certainly might 
be possible, although in the large herbivora always difficult, to expose 



11 



Fig. 132. — 

Tceniaechino- 
coccus. 



288 



DISEASES OF THE LIVEK. 



the liver and to puncture and evacuate the contents of some of the 
cysta; but the result would be illusory, because some vesicles would 
always be inaccessible, and economically intervention would be incomplete 
and useless. 

Although there is no useful method of treatment, prophylaxis is 
possible and valuable. It consists in preventing the development of 
taeniae in farm and sporting dogs. For this purpose it is sufficient to 
prevent their obtaining raw offal containing vesicles of echinococci from 
sheep, oxen, or pigs, and also to free them from any helminths which 
they may harbour. In this way they no longer spread eggs of taeniae 




^rxx?Z&C OaI riaX' <^ jiof-^- 

Fig. 133. — Pig's liver with echinococciis cysts. (After Eailliet.) 

with their faeces in the neighbourhood of ponds or drinking places, and 
the cattle do not ingest the embryos. 



SUPPURATIVE ECHINOCOCCOSIS. 

Causation. Simple echinococcosis may remain undetected for a long 
time, and young animals affected with it may grow up without exhibiting 
marked general disturbance. The old echinococci end by degenerating, 
the wall of the cyst becomes modified, the liquid it contains, turbid, 
lactescent, then caseous ; the vesicle becomes wrinkled, and finally 
nothing resembling the primary vesicle remains. The liquid is soon 
absorbed, and the primary cyst is only represented by a caseous magma, 
which undergoes calcareous infiltration and progressive atrophy. 

Under other circumstances the development of the echinococcus 



SUPPURATIVE ECHINOCOCCOSIS. 289 

Vesicles is less regular ; they may become accidentally infected and 
transformed into encysted abscesses, constituting suppurative echino- 
coccosis of the liver. The membrane of the vesicles usually resists the 
passage of microbes, but the fibrous tissue surrounding the cyst is very 
vascular ; and if, in consequence of vascular disturbance in the liver 
(which may result simply from feeding, trifling infection or other visceral 
disease), the blood should for a short time be infected, microbes pene- 
trate through solutions. of continuity in the wall of the vesicle, which 
becomes a centre of suppuration. The liquid becomes turbid, the primary 
cyst is transformed into an abscess, and suppurative echinococcosis is 
set up. 

Symptoms. The general condition resulting from the development 
of suppuration in echinococcus cysts is very different from that of true 
echinococcosis. If the abscess develops rapidly, acute generalised peri- 
tonitis or localised peritonitis of the right anterior abdominal region 
may almost immediately occur, producing all the characteristic symj)toms 
of ordinary peritonitis. In all cases, even in the absence of well-marked 
peritonitis, perihepatitis occurs, and the liver becomes adherent to the 
posterior surface of the diaphragm, to the hypochondriac region, to the 
abdominal wall, or to one of the gastric compartments. 

This perihepatitis is indicated by exceptional sensitiveness in the right 
hypochondriac region, and by respiratory disturbance due to fixation of 
the diaphragm. 

In certain cases these abscesses seem to develop like " cold " abscesses 
— i.e., without fever, and this without producing very marked digestive 
disturbance ; but the patients waste rapidly, become weak, show slight 
subicteric coloration of the membranes, and appear to lose their 
strength. Movement is slow and hesitating, as though the animals 
were suffering from laminitis, the anaemia becomes more marked from 
day to day, and examination of the blood reveals abundant leucocytosis, 
the existence of which often assists in the diagnosis of internal suppura- 
tion. In a few months, at least in the cases we have seen, the animals 
become cachectic. 

In other and still more obscure cases suppuration of the liver is 
accompanied by total hypertrophy, excessive sensitiveness in the right 
hypochondriac region, progressive loss of appetite, excessive thirst, and 
uncontrollable diarrhoea and fever, although in the case mentioned above 
there was little fever and no diarrhoea. The course of these cases, which 
probably result from intestinal infection, is much more rapid. In a 
fortnight or three weeks, sometimes less, the patients are carried of! by 
intoxication, generalised purulent infection, or septicaemia. 

Diagnosis. The diagnosis of suppurative echinococcosis and of 
primary abscess of the liver is difficult to establish. It is attained 

D.C. U 



290 



DISEASES OF THE LIVER. 




Fig. 134.— Thin - necked 
bladder - worm {Cysti- 
cercus tenuicoUis), with 
head extruded from 
body, from cavity of 
a steer, natural size. 
(Stiles, Annual Eeport, 
U.S.A. Bureau of Agri- 
culture, 1901.) 



chiefly by a process of exclusion, though the signs 
furnished by percussion of the right flank, and by 

examination of the blood, 
are of some assistance. 

Prognosis. The prog- 
nosis is extremely grave. 
Treatment is of little 
value. Even supposing 
that the diagnosis has been 
exact, surgical intervention 
is out of the question, and 
only this would appear 
theoretically to offer a 
chance of success. The 
abscesses are multiple, 
deeply placed, separated 
from one another, and 
sometimes surrounded by 
enormous tracts of in- 
flamed tissue. In fact, the condition is of such a 
character as entirely to prohibit active measures. 

CYSTICERCOSIS. 

This disease is produced by the thin- or long- 
necked bladder-worm {Cysticercus tenuicoUis) found 

in cattle, sheep, and swine. 
The cysticercus represents 
an intermediate stage of de- 
velopment of the marginate 
tapeworm {Tcenia margi- 
nata) of dogs and wolves. 
It is by no means un- 
common in Europe and 
America, and occurs in the 
body cavity of cattle, sheep, 
swine, and other animals, 
attached to the diaphragm, 
omentum, liver, or other 
organ. 

When eaten by dogs or 
wolves, it develops into the 
marginate tapeworm, which was formerly confused 
with T. solium of man, and gave rise to the 





Fig. 136.— Head of the 
marginate tapeworm 
{Taenia 7narginata). 
X 17. (Stiles, Annual 
Eeport, U.S.A. Bureau 
of Agriculture, 1901.) 



i^=-:v»Jci 



m 



Fig. 135. — The marginate 
tapeworm {Tcenia mar- 
ginata), natural size. 
(Stiles, Annual Eeport, 
U.S.A. Bureau of Agri- 
culture, 1901.) 



CYSTICERCOSIS. 



291 



erroneous idea that the pork-measle tapeworm occurs in dogs as well 
as in man. 

Life history. In tracing the life history it is hest to begin wdth the 




Fig. 137. — Small and large hooks of (A) Tcenia marginata, (B) T. serrata, and (C) 
T. coenurus, a, Small hooks ; 6, large hooks, x 480. (After Deffke.) 



egg, produced by the adult tapeworm in the intestine of dogs. These 
eggs, containing a six-hooked embryo, escape from the dog with the 




\^ 







Fig. 138. — Sexually mature segment of the margmate tapeworm {Tcenia marginata), 
cp, Cirrus pouch; gp, genita.1 pore ; n, nerve ; ov, ovary ; sg, shell gland ; t, testicles ; 
tc, transverse canal; tit, uterus; v, vagina; vc, ventral canal; vd, vas deferens 5 
vg, vitellogene gland. Enlarged. (After Deffke.) 

u 2 



292 



DISEASES OF THE LIVER. 




excrements, and are scattered on the ground, either smgly or confined 
in the escaping segments of the tapeworm. Once upon the ground, 
they are easily washed along by rain into the 
drinking water, ponds, or brooks, or scattered on 
the grass. Upon being swallowed with fodder or 
water, they arrive in the stomach of the inter- 
mediate host (cattle, sheep, etc.), where the egg- 
shells are destroyed and the embryos set free. 
The embryos then traverse the intestinal wall, 
and, according to most authors, arrive either ac- 
tively, by crawling, or passively, by being carried 
along by the blood, in the liver or lungs, where 
they undergo certain transformations in structure. 
While still in the finer branches of the blood- 
vessels of the liver, which they transform into 
small, irregularly-shaped tubes about 12 to 15 mm. 
long and 1 to I'o mm. broad, the embryos lose their six hooks, and 
develop into small, round kernels, which are generally situated at one 



Fig. 139.— Egg of the 
niarginate tapeworm 
( Tcenia m arginata) , 
with six-hooked em- 
bryo, greatly magni- 
fied. (Stiles, Amiual 
Eeport U.S. A.Bureau 
of Agriculture, 1901.) 




Fig. 140.— Portion of the liver of a lamb which died nine days after feeding with eggs 
of the marginate tapeworm [Tcsnia marginafa), with numerous "scars," due to 
young parasites. (After Curtice.) 

end of the tubes. The embryo can first be seen about four days after 
infection. The " scars " (Figs. 140 and 141) described in the liver of 



DISTOMATOSIS — LIVER FLUKK DISEASE — LIVER ROT. 293 

animals infested with Cysikercus tenuicollis are nothing more nor less 
than these tnhes, or altered blood-vessels, caused by the growth and 
w^andering of the parasites. 

Curtice takes a somewhat different view — -that is, he considers the 
liver as a place of destruction for the young parasites, rather than a 
normal place for their development; he also claims that the embryos, 
which may even travel the entire length of the intestine of the inter- 
mediate host, traverse the intestine and arrive directly in the position 
w^here they complete their larval development without first passing 
through the liver. 

After developing into the fuU-grow^i bladder worm, the parasites 
remain unchanged until they are devoured by a dog or wolf, or until, 




Fig. 141. — Cross-section of the liA'er of a lamb which died nine days after feeding with 
eggs of the niarginate tapeworm [Tcenia marginata). (After Curtis.) 

after an undetermined length of time, they become disintegrated and 
more or less calcified. 

If the hydatid is devoured by a dog or w^olf, either wdien the latter 
prey upon the secondary host or when the dog obtains the cyst at a 
slaughter-house, the bladder portion is destroyed, the scolex alone 
remaining intact in the digestive fluids. The head holds fast to the 
intestinal wall with its suckers and hooks ; by strobilation (transverse 
division) it gives rise to the segments, which as we have already seen, 
together with the head, go to make up the adult tapew^orm. Kepro- 
ductive organs of both sexes develop in the separate segments, and 
eggs are produced, within which are developed the six-hooked embryos, 
the point from which we started. 

DISTOMATOSIS-LIVER FLUKE DISEASE— LIVER ROT. 

In France the name of distomatosis has been given to a disease caused 
by the presence of distomata in the bile ducts. It is the " liver rot " of 
England, the Eberfiiule of Germany, and is produced by the growth in 



294 



DISEASES OF THE LIVER. 



the biliary ducts of oxen, sheep, and goats of two species of distomata, 
viz., the Distoma hepaticum or Fasciola hepatica, and the Distoma lanceo- 
latiim. 

In 1875 Zimdel established the causative relation between the pre- 
sence of distomata in the liver and the development of progressive fatal 

cachexia in most of the animals affected. This 
^ opinion was emphasised by the works of Leuckart 

and Thomas on the development of distomata, 
and at the present day the parasitic theory is 
accepted as beyond question. 

Fasciola hepatica {Distama liepatkum). — The 
common liver fluke of cattle, sheep, swine, etc. 

Life history. The adult parasite, instead of 
producing young similar to itself and capable 
of developing directly into adults in cattle, pro- 
duces eggs which develop into organisms totally 
different from the adult form, living a parasitic 
life in other animals. In scientific language, the 
parasite is subject to an alternation of genera- 
tions, together with a change of hosts. The fol- 
lowing summary of the life history will make this point clear: — 

{a) The adult Jienitapliroditic worm (Figs. 144 and 145) fertilises itself 
(although a cross fertilisation of two individuals is not impossible) in the 
biliary passages of the liver, and produces a large number of eggs. 

(b) Eggs (Fig's. 143, 146 and 147). — Each egg. is composed of the 




Fig. 142. — FasciolaJiepa- 
tica. A, 3^oung ; B, 
adult parasite. (After 
Railliet.) 






Fig. 143. — Eggs of Fasciola hejjatica. A, 
from the bile duct ; B, embryonic ; C, after 
opening. (After Railliet.) 




Fig. 144. — Common liver 
fluke {Fasciola hepa- 
tica), natural size. 
(Stiles, Annual Report, 
U.S.A. Bureau of Agri- 
culture, 1901.) 



following parts : (1) A true germ cell, which originates in the ovary and is 
destined to give rise to the future embryo ; (2) a number of vitelline or 
yolk cells, which are formed in a specialised and independent portion 
(vitellogene gland) of the female glands — instead of developing into embryos 
the yolk cells form a follicle-like covering for the true germ cell, and play 
an important role in the nutrition of the latter as it undergoes further 



DISTOMATOSIS— LIVER FLUKE DLSEASE— LIVER ROT. 



295 



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296 



DISEASES OF THE LIVER. 



development ; (3) a shell surrounding the germ cell and vitellme cells, 
and provided at one end with a cap or operculum. The eggs escape from 
the uterus of the adult through the vulva, are carried to the intestine of 
the host with the bile, then pass through the intestines with the contents 




Fig. 146. — Egg of the common liver 
fluke {Fasciola hejjatica), exa- 
m.ined shortly after it was taken 
from the liver of a sheep. At one 
end is seen the lid or operculum, o ; 
near it is the segmenting ovum, e ; 
the rest of the space is occupied 
by yoke cells which serve as food ; 
all are granular, but only three 
are thus drawn. X 680. (After 
Thomas, 1883, p. 281, Fig. 1.) 



^.. 




...^ 



Fig. 147. — Egg of the common liver 
fluke containing a ciliated embryo 
(miracidium) ready to hatch out : 
d, remains of food ; e, cushion of 
jelly-like substance ; /, boring pa- 
pilla ; li, eye-spots ; A-, germuial 
cells. X 680. (After Thomas, 
1883, p. 283, Fig. 2.) 



of the latter, and are expelled from the host with the f secal matter. Many 
of them become dried, and then undergo no further development; but 
others are naturally dropped in the water in marshes^ or, being dropped 
on dry ground, they are washed into water by the rain, or are carried to 
a more favourable position by the feet of animals pasturing or passing 
through the fields. After a longer or shorter period of incubation, which 



DISTOMATOSIS — LiVER FLUKE DISEASE — LIVER ROT. 



297 



varies with the temperature, a ciUated embryo {miracidium) is developed. 
At a temperature of 20° to 26° C. the miracidium may be formed in ten 
days to three weeks ; at a temperature of 16° C. the development takes 
two to three months; at 38° C. it ceases entirely. Experiments have 
shown that as long as these eggs remain in the dark the miracidium will 
not escape from the egg-shell; accordingly it will not escape during the 
night. When exposed to the light, however, or when suddenly brought 




Fig. 148.— Embryo of the 
common liver flul^e {Fas- 
ciola liejpatica) , boring into 
a snaiL X 370. (After 
Thomas, 1883, p. 285, 
Fig. 4.) 




Fig. 149. — Sporocyst 
of the common hver 
fluke which has de- 
veloped from the 
embryo, and con- 
tains germinal cells. 
X 200. (After 
Leuckart, 1889, p. 
109, Fig. 67 B.) 




Fig. 150.— Sporocyst 
of the common hver 
fluke, somev^^hat 
older than that of 
Fig. 149, in which 
the germinal cells 
are giving rise to 
rediae. x200. (After 
Leuckart, 1889, p. 
109, Fig. 67 0.) 



into contact with cold water, the organism bursts the cap from the 
egg-shell, crawls through the opening, and becomes a — 

(c) Free-swimming ciliated miracidium (Fig. 148). — As already stated, 
this organism is entirely different from its mother. It measures about 
0'15 mm. long; is somewhat broader in its anterior portion than in its 
posterior portion ; on its anterior extremity we find a small eminence, 
known as a boring papilla ; the exterior surface of the young worm is 
covered with numerous cilia, which by their motion propel the animal 
through the water ; inside the body we find in the anterior portion a 
simple vestigial intestine and a double ganglionic mass provided with a 
peculiar pigmented double cup-shaped eye-spot ; in the posterior portion 



298 



DISEASES OF THE LIVER. 



of the body cavity are found a number of germ cells, which develop into 
individuals of the next generation. 

Swimming about in the water, the miracidium seeks out certain snails 
{LimncEa truncatida, L. oaliuensis, L. rubella), which it immediately attacks 
(Fig. 148). The miracidium elongates its papilla and fastens itself to the 
feelers, head, foot, or other exterior soft portion of the body of the snail ; 




Fig. 151. — Kedia of the 
c o m m o n liver fluke 
[Fascio la liejp at tea), 
containing germinal 
cells which are clevelop- 
ingintocercariae. Xl50. 
(After Lenckart, 1889, 
p. 269, Fig. 129 A.) 




Fig. 152.— Eedia of the 
common liver fluke, 
with developed cerca- 
riae. X 150. (After 
Leuckart, 1889, p. 270, 
Fig. 130.) 




Fig. 153. — Free cercaria 
of the connnon liver 
fluke, showing two 
suckers, intestine, large 
glands, and tail. (After 
Leuckart, 1889, p. 279, 
Fig. 137.) 



some of the parasites enter the pallial (lung) cavity and attach themselves 
there. After becoming securely fastened to the snail the miracidium 
discards its ciliated covering, and shortens to about half its former length 
(0'07 mm. to 0'08 mm.). The parasites now bore their way into the body 
of the snail, and come to rest in the liver or near the roof of the pallial 
cavity, etc. ; the movements gradually cease, and we have before us the 
stage known as the — 

(d) Sporocyst (Figs. 149 and 150). — The eye-spots, ganglionic swellings, 
and vestigial intestine become more and more indistinct, and are finally 



DISTOMATOSIS — LIVER FLUKE DISEASE — LIVER ROT. 



299 



lost. The sporocyst grows slowly at first, then more rapidly, and at the 
end of fourteen days or so measures 0'5 mm. The germ cells mentioned 
as existing in the posterior portion of the miracidium now develop into 
individuals of a third generation, known as — 

(e) BedicE (Figs. 151 and 152). — The redige escape from the sporocyst 
w^hen the latter are from two weeks (in summer) to four weeks (in late 
fall) old. Upon leaving the body of the sporocyst they wander to the 
liver of the snail, where they grow to about 2 mm. long by 0'25 mm. 
broad. Each redia consists of a cephalic portion, which is extremely 
motile, and which is separated from the rest of the young worm by a 
ridge ; under the latter is situated an opening, through w^hich the next 




Fig. 154. — Portion of a grass stalk with three encapsuled 
cercariae of the common liver fluke {Fasciola hepatica). 
X 10. (After Thomas, 1883, p. 291, Fig. 13.) 




Fig-. 155. — Isolated en- 
cj^sted cercaria of the 
common liver fluke. 
• X 150. (After Leuc- 
kart, 1889, p. 286, 
Fig. 142.) 



generation (cercariae) escape. The posterior portion of the w^orm is pro- 
vided, at about the border of the third and the last fourths of the body, 
with two projections. There is a mouth with pharynx situated at the 
anterior extremity, the pharynx leading to a simple blind intestinal sac. 
The redia, as well as the sporocyst, may be looked upon as a female 
organism, and in its body cavity are found a number of germ cells, which 
develop into individuals of the next generation, known as — 

(/) CercaricE (Figs. 153 — 155). — These organisms are similar to the 
adult parasites into wdiich they later develop. The body is flat, more or 
less oval, and provided with a tail inserted at the posterior extremity. 
The oral sucker and acetabulum are present as in the adult, but the 
intestinal tract is very simple; on the sides of the body are seen two 
large glands, but the complicated genital organs of the adult are not 
visible, The cercaria leaves the redia through the birth opening, remains 



300 



DISEASES OF THE LIVER. 



in the snail for a longer or shorter time, or passes out of the body of the 
snail and swims about in the water. After a time it attaches itself to a 
blade of grass (Fig. 154) or some other object, and forms a cyst around 
itself with material from the large glands, at the same time losing its 
tail. It now remains quiet until swallowed by some animal. Then, upon 
arriving in the stomach — of a steer, for instance — the cyst is destroyed, 
and the young parasite wanders through the gall-ducts or, as some believe, 




Fig. 156. — Drawing from a microscopic preparation, showing a haemorrhage in the 
parenchyma of the hver caused by the common Uver fluke (Fasciola hepatica). 
a, Atrophic hver tissue ; b, round-cell infiltration ; c, a portion of the parasite ; 
d, haemorrhage. (After Schaper, 1890, PI. I., Fig. 1.) 



through the portal veins to the liver, where it develops into the adult 
hermaphrodite. 

From the above we see that this parasite runs through three genera- 
tions, namely : 

(1.) Ovum, miracidium, and sporocyst . . . first generation. 

(2.) Eedia . . . second generation. 

(3.) Cercaria and adult . . . third generation. 

During this curious development, w^hich lasts about ten to twelve 
weeks, there is a constant potential increase in the number of individuals, 
for each sporocyst may give rise to several (five to eight) rediae, each 
redia to a larger number (twelve to twenty) cercarise, and each adult to an 



DISTOMA.TOSIS — LIVEK FLUKE DISEASE — LIVER ROT. 



301 



enormous number (37,000 to 45,000) of eggs. This unusual fertility of the 
parasite is necessary because of the complicated life history and the com- 
paratively small chance any one egg has of completing the entire cycle. 

Hosts. An interesting and, from an agricultural standpoint, an 
important matter connected ^yith this fluke is that it is found in a large 
number (about twenty-five) of domesticated and wild animals, and this 







Fig. 157. — Drawing from a microscopic preparation, showing the glandular hyper- 
plasia of the mucosa of a gall-duct caused b}^ the common liver fluke {Fasciola 
hepatica). a, Hypertrophied submucosa ; h, interstitial connective tissue; c, com- 
pressed lobule ; d, lumen of the gall-duct — thickened fibrous wall of the gall-duct. 
(After Schaper, 1890, PI. I., Fig. 2.) 

fact probably explains to some degree the ^Yide geographical distribution 
of the parasite. 

Symptoms. The symptomatology of this disease may clinically be 
divided into three well-marked periods : 

I. Primary period. The primary phase commences with the pene- 
tration of the embryos of the parasite into the bod}^ firstly into the 
intestine, and then into the liver by ascending the bile ducts. This phase 
occurs during the last months of the year, October, November, and 
December, and is rarely accompanied by alarming symptoms. At this 
time the sheep appear in good health, the summer being over, and the 



302 



DISEASES OF THE LIVER. 



animals, being well nourished and fat, are able to resist the first attacks 
of the parasite, so that even an observant shepherd only notices a little 
dulness, want of condition, and muscular weakness. It requires a care- 
fully trained eye to note these very general symptoms, for the bodily 
condition only changes very slowly and progressively, the appetite remain- 
ing good. Experienced butchers, however, in the districts where disto- 
matosis is common, readily detect this condition. The animals make 
little resistance when handled. 

Nevertheless, even in this primary phase, the conditions are not always 




Fig. 158.— Drawing from a microscopic preparation showing a fluke in the tissue of 
the liver, a, Necrotic Hver tissue ; h, atrophic liver cells ; c, spines on the fluke, 
showing the outline of the body. (After Schaper, 1890, PL III., Fig. 5.) 

as above sketched, and a certain number of deaths may occur. Gerlach 
has mentioned the possibility of death by cerebral apoplexy, in conse- 
quence of the young distomata penetrating to the brain. Moussu has 
certainly never seen such a complication, but has seen death from 
hepatitis, perihepatitis, and secondary pericarditis in animals gravely 
infested. The young embryos, whether they penetrate only by the bile 
ducts, as has been stated, or are carried to the liver by the blood stream, 
often excavate canals in the substance of the gland before establishing 
themselves in the bile ducts. They make their way as far as Glisson's 
capsule, and may even penetrate it ; and as they carry with them innumer- 
able intestinal germs, when they arrive via the bile ducts, they set up 



DISTOMATOSTS — LIVER FLUKE DISEASE — LIVER ROT. 



303 



hepatitis, perihepatitis, with the formation of numerous false mem- 
branes, or even infectious fibrinous peritonitis. Should the patients die 
during this phase one finds young distomata at the surface of the liver, 
or even in the thickness of the false membranes. 



Jan. "Feb. Mar Apr. May ilun. July. Aug Sejt. Oct. Nov. Dec. 



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Fig. 159.— Tabular diagram of the occurrence of the common hver fluke [Fasciola 
hepatica) dunng different months of the year, a, Cattle; h, sheep; c, swine. 
(After Leuckart, 1889, p. 301, Fig. 147.) 



When infestation is discrete the appearances are quite different. 
Careful breeders have even stated that at this period the young sheep 
appear to show a greater tendency to fatten. 

II. Second period. In the primary phase deaths are exceptional; they 



804 



DISEASES OF THE LIVER. 



only become common towards the end of the winter. Dm^ing the second 
or middle i3eriod (December and January) the patients lose flesh, appear 
less active, show less regular appetite and greater thirst. The conjunctiva 
becomes pale and swollen, the sclerotic has a bluish tint, and the eyelids 
are somewhat infiltrated. The wool appears drier and less curly ; locks 
of wool part readily from the skin, and the individual fibres become dry 
and fragile. 

This phase is accompanied by very marked anaemia, rapid exhaustion 
during movement, and inability to run for any length, 
of time. 

The different methods of examination reveal 
nothing specially striking, except that the valvular 
sounds of the heart are sharper, and that trifling 
oedema occurs under the thorax and abdomen. 

Microscopic examination of the faeces reveals the 
presence of eggs of distomata. The sheep rapidly 
become thin from about the end of January, even 
although the appetite persists and nourishing food 
is given. 

III. Third, or wasting, period. The decline, 
which sets in about February, appears extremely ob- 
stinate, and resists all treatment. 

The patients become feeble, eat less, and digest 
badly. Submaxillary oedema, common to advanced 
wasting diseases, then appears. If the sheep are re- 
moved from the fold to pasture, the swelling of the 
submaxillary space is very noticeable. It consists in 
an indolent oedematous tumefaction, which disappears 
when the animals are travelled, but reappears when 
grazing on account of the low position in which the 
head is then held. 

The condition then becomes complicated with 
diarrhoea, and soon grows alarming. On examination, extensive dropsy 
may often be found in the thorax, pericardium, and abdomen. 

Death results from exhaustion ; the animals do not appear to suffer, 
but become extraordinarily anaemic, and perish without a struggle. The 
blood is simply rosy in colour, like gooseberry syrup : the clot is soft 
and gelatinous : the number of red blood corpuscles has fallen from 
about seven millions to a few hundred thousand. 

Icterus is rare, though certain cases have been described where it has 
appeared during the last and even during the middle stage. 

When animals begin to die in a district which has long been infested, 
the losses are enormous, the condition sometimes constitutes a perfect 




Fig. 160.— The large 
American fl u k e 
(Fasciola magna), 
natural size. 
(Stiles, Annual 
Report, U.S.A. 
Bureau of Agricul- 
ture, 1901.) 



DISTOMATOSIS — LTVER FLUKE DISEASE — LIVER ROT. 



305 



"^nr 



scourge. It should be remarked, ho^Yever, that all those affected do not 
die ; animals kept under good conditions may even survive for several 
months, although greatly wasted. 

Towards March and April the parasites leave their position, and are 
conveyed by the current of bile towards the intestine, to be rejected 
with the faeces. This is the period of convalescence and recovery; but 
recovery is only relative, for the parasites are never entirely evacuated. 
The distomata then recommence their 
life cycle outside the animal body. 

Unfortunately the mortality caused by 
distomata is accidentally aggravated by 
other diseases, and the scourge then be- 
comes an absolute disaster for the dis- 
tricts where such complications occur. 
Thus Besnoit and Cuille, of Toulouse 
have shown that distomatosis may be- 
come complicated with a form of very 
rapidly fatal hsemorrhagic septicsemia, 
produced by an ovoid bacterium. 

Distomatosis, already sufficiently 
grave, then becomes infinitely more 
serious, if only from the fact that it 
may prove the point of origin of an 
absolutely fatal complication. 

In bovine animals the symptoms de- 
velop exactly as in sheep, though the 
cachectic period is uncommon and the 
injury done is often less important than 
in sheep. The patients exhibit irregular 
appetite, wasting Avithout appreciable 
cause, anaemia, and even diarrhoea. In 
spite of excellent winter feeding they 
do not regain condition, and relative re- 
covery only sets in with the approach of spring. Death from simple 
distomatosis is exceptional, but in animals so predisposed enteritis de- 
velops more easily, as do all forms of infection of intestinal origin. 

The disease is, however, also grave for bovines because successive 
reinfection occurs, and the disease may be prolonged for years. 

Causation. Distomatosis is due to one cause, viz., the entrance of 
embryo flukes into the digestive apparatus of herbivora. 

The adult distomata in the biliary ducts continually discharge large 
quantities of eggs, though the process is most active between February 
and June or July. The eggs are carried away with the bile and faeces 

D.C. X 




Fig. 161. — Macerated specimen 
of large American fluke, show- 
ing the digestive system and 
acetabulmii. X 2. (After Stiles, 
1894, p. 226, Fig. 2.) 



806 



DISEASES OF THE LIVER. 



and pass oil to the pastures, where they continue then- hfe cycle, thanks 
to moisture and the presence of stagnant water. The embryos, having 
escaped from the egg, enter the bodies of the snails found in or near 
stagnant water {Limncea trimcatula), become converted into sporocysts, 
and afterwards into rediae and cercaripe. The cercarige become encysted 
on the lower surface of blades of grass m damp pastures, whence they 
are transferred to the animals' stomachs along with the grass itself. 

As the Limncea truncatula lives not only in marshy regions, but also 
in all damp situations, the embryos of distomata are distributed over 

enormous areas, and the disease itself is 
equally widespread. The embryo, after in- 
gestion, is set at liberty, and passes from the 
intestine into the innermost recesses of the 
liver, being guided up the bile ducts by 
the current of bile. At this point it attaches 
itself to the wall of the bile duct, passes 
through its various stages of evolution, and 
attains the adult form. It then begins lay- 
ing eggs, and thus starts a new evolutionary 
cycle. 

The life cycle of Distoma lanceolatum is 
not yet known, and this variety, moreover, 
is less widely distributed than the Distoma 
liepaticum. 

The bile ducts are more easily pene- 
trated by the distoma in young aninials, a 
fact which explains why calves and lambs 
are particularly affected. Adults present a 
less favourable nidus, a fact which renders 
them less easily infected, but does not en- 
tirely prevent the parasites from attacking 
them. Old animals, although unable to resist entirely, seldom harbour 
many of the parasites. 

Wet years aiopear to favour the extension and propagation of dis- 
tomatosis in an extraordinary fashion, a fact which is easily understood, 
if we regard the phases of evolution of the parasite. The autumn appears 
particularly favourable to the infection of herds. This is explained by 
the fact that, during the summer, the dryness of the fields entirely pre- 
vents the development of such eggs as may be distributed over them ; 
whilst wet periods during the autumn favour this development. 

On the other hand, the grass becomes eaten down in autumn, so that 
the animals gather it almost level wdth the ground. As the cercariae 
attach themselves to the lowest leaves they are then ingested in much 




Fig. 162. — Limncea trunca- 
tula. Natural size and mag- 
nified. (After Eailliet.) 



DISTOMATOSIS — LIVER FLUKE DISEASE — LIVER ROT. 307 

larger quantities. The bad effects of wet seasons are not immediately 
apparent, but appear during the following spring. 

Distomatosis is common throughout almost the whole of Europe, 
Africa, and America. In France it is most serious in the moister 
regions of Sologne, in Berry, the mountainous and wet districts of the 
great central plateau, and particularly in the Pyrenees. It particularly 
attacks oxen in the valley of the Meuse, the marshes of Picardy, the 
lower regions of Normandy, and in all the mountainous pastures of the 
central plateau. 

Lesions. The lesions of distomatosis vary with the stage of develop- 
ment of the parasites. During the primary phase of invasion of the 
bile ducts by young distomata one finds interstitial diffuse hepatitis, due 
to perforation of the gland by young parasites, adhesive i)erihepatitis, 
with the formation of false membranes, and not uncommonly slight 
peritonitis. 

Zoologists state that the young distomata penetrate the liver by 
passing upwards against the current of bile. It does not appear impos- 
sible, however, that they may penetrate by another path, particularly as 
so-called "erratic" forms of distomatosis like distomatosis of the lung, 
heart, lymphatic glands, and various other tissues are not uncommon. 
It has been suggested that the young distomata, arriving in the bile 
ducts, perforate the gland, giving rise to these lesions of perihepatitis, 
peritonitis or erratic distomatosis ; but this view is scarcely in harmony 
with the fact that the parasites are usually found in the bile ducts. 

During the second phase, corresjDonding to the development of almost 
adult distomata, the perihepatitis and peritonitis set up either produce 
fatal results by secondary infection or diminish and disappear. The 
parasites develop in the bile ducts, in which they attain the adult con- 
dition. They steadily ascend towards the origins of the ducts, dilating 
them in their passage in an extraordinary way. The number of para- 
sites varies greatly : sometimes there are but few% and they are only 
discovered on post-mortem examination ; in other cases the bile ducts are 
crammed with them, as many as six or seven hundred or even a thousand 
being present. The distended bile ducts always show chronic peripheral 
inflammation, which steadily becomes aggravated, producing pericanali- 
cular atrophying sclerosis. This condition is followed by change in and 
disappearance of a certain quantity of hepatic tissue, and by various 
forms of vascular and secretory disease. 

This is the period of greatest disturbance, not only in consequence of 
the actual presence, but also of the mode of living, of the parasites. 

Moussu declares that the parasites live principally on blood, at least 
during the first and second stage of their sojourn in the liver, adducing 
as proof that if one completely injects the vascular system of the liver 

X 2 



808 DISEASES OP THE LIVER. 

(arteries and veins), some of the injected matter will be found a day 
afterwards in the digestive apparatus of the parasites. 

The disturbances Avhich they produce are therefore due to their 
actual presence and its consequences, to their mode of life, and to the 
intercurrent infections of which they are sometimes the initial cause. 

It is idle to object that the part played by these parasites is less 
important than has been suggested, and that the mortality results from 
intercurrent infection, and not from the parasites themselves. It is 
equally idle to point out that carcases of animals suffering from severe 
infection with distomata, particularly the carcases of sheep, are frequently 
found in slaughter-houses, in perfectly fat condition, and with the appear- 
ance of not having suffered in any way. These observations are perfectly 
correct and well founded. But it matters little that death results from 
an infection superadded to the distomatosis, if the presence of distomata is 
the determining factor in causing the superadded infections, and if such 
infection is, as Moussu believes, almost inevitable in animals already 
exhausted by the action of the parasites. 

The fact that animals suffering from distomatosis and slaughtered for 
food are well nourished is not a valid objection ; for it has long been 
known that wasting and anaemia are not immediate consequences, and 
that before they are clearly apparent the distomata must have been 
present in the liver for several months. Bakewell and the Marquis 
of Behague have shown that in moderately infected animals there is 
a tendency to lay on flesh during the first and a portion of the second 
stage of development of the disease. 

If the animals are slaughtered before the period of progressive 
decline sets in, it is quite possible to form entirely wrong views regard- 
ing the importance of these parasites. 

The wasting process commences towards the end of the second phase 
of the disease, and then makes rapid progress. The parasites, which 
have then been continuously drawing on the blood for their nourishment 
for a long time, produce anaemia, and some infection of the bile ducts, 
and usually a certain degree of icterus. 

The third phase is accompanied by general signs of cachexia, which 
need not again be described. They are similar to those of all pro- 
gressive cachexias. In animals which survive this phase and are 
ultimately slaughtered the liver always shows very marked sclerosis, 
commencing around the biliary ducts. Even after the parasites have 
been evacuated, these ducts appear indurated, thickened, fibrous, and 
sometimes encrusted with biliary deposits or obstructed with true calculi. 
These calculi may or may not contain parasites ; sometimes they simply 
contain eggs : they are open, tubular, and perforated, but always irregular 
on the surface. 



DISTOMATOSIS — LIVER FLUKE DISEASE — LIVER ROT. 309 

When in addition complications have appeared, one usually finds 
general lesions of septicaemia and blood infection. 

In erratic distomatosis, which is of no importance clinically, disto- 
mata may become encysted in the lung or other viscus, and in time 
die. The cysts, which only contain one and rarely two parasites, 
present a fibrous shell, enclosing a blackish, pultaceous, grumous 
magma, which sometimes has undergone a certain amount of calcareous 
infiltration. The parasite may be entirely destroyed. 

Diagnosis. Early diagnosis is difficult, and can only be established 
by microscopic examination of the excreta and the discovery of eggs. 
On an average one may find one egg in each preparation when the 
liver contains 80 to 100 flukes. When wasting is very marked, and 
particularly when there has already been a number of deaths, diagnosis 
becomes extremely easy. It is sufficient to find flukes in any form 
{Distoma hepaticum vel lanceolatum) to be assured as to the cause of 
disease. 

Prognosis. In severely infested cases the prognosis is extremely 
grave, because no efficient method of treatment exists. Embedded 
in the liver, the parasites resist the action of all drugs, and we know 
of no anthelmintic eliminated by the bile which in any way affects 
their vitality. When the disease is recognised early, the most econo- 
mical method is to fatten the animals as rapidly as possible and 
prepare them for slaughter. 

Treatment. There is no reliable curative treatment. The drugs 
which one might employ would kill the animal before poisoning the 
parasites embedded in the liver. Various mixtures containing sulphate 
of iron, juniper leaves, etc., have been recommended; but rich food 
constitutes the best of all treatment, both from a curative and a pro- 
phylactic standpoint. 

With the view of preventing the disease, however, and protecting 
flocks from attack in places where the disease is common, certain 
precautions should be adopted. They comprise — (a) providing a free 
supply of rock-salt, either in masses placed in the mangers or dis- 
tributed with the food ; the salt increases gastric secretion, and has 
a slight action on the parasites : (b) adding to the food during the 
first months of winter branches of birch, juniper, willow, and broom ; 
the leaves of these plants contain aromatic or resinous principles 
which act on the liver, are eliminated by the bile, and may have 
valuable results. 

But of all preventive measures the most effective consist in draining, 
cleansing, and drying low, moist, or marshy lands, because the molluscs 
which are essential to the life cycle of the parasites are unable to 
develop where the soil is dry. The manure containing the eggs of 



310 DISEASES OF THE LIVER. 

the parasites may be disinfected by adding to it lime, sulph'ate of iron, 
or common salt. Common salt and lime spread over the pastm^es 
has a double beneficial influence, acting both as a manure and as a 
parasiticide. From May to August is the best time for spreading 
this dressing. 

The fluke embryos are destroyed by 1 to 2 per cent, solutions of 
common salt, and by f per cent, solutions of lime. 

In over-stocked fields the animals are obliged to graze very close 
to the ground, and are thus more exposed to infection. Over-stocking 
should therefore be avoided. Animals should not be left too long on 
the same ground. If infected they should at once be driven to higher 
pastures. Eaised water tanks can be placed in the pastures — they are 
less likely to become infected. Animals from known infected flocks 
or herds should not be purchased. Livers from infected animals 
should be cooked or destroyed. If eaten raw^ by dogs the eggs pass 
uninjured through the dog's intestine and infect fresh pastures. 

Sulphate of iron distributed in quantities of 250 to 400 lbs. per 
acre is valuable as a manure, and would probably have a greater 
effect in destroying the embryos. 



SECTION III. 

RESPIRATORY APPARATUS. 

CHAPTER I. 

EXAMINATION OF THE RESPIRATORY APPARATUS* 

From the clinical standpoint a study of the respiratory apparatus 
implies the examination of the nostrils, nasal cavities, frontal and 
maxillary sinuses, larynx, trachea, and, for the purpose of ascertain- 
ing the condition of the lungs and pleura, of the chest. 

Nasal cavities. Examination of the external portion of the nasal 
cavities is extremely simple. The observer notes the degree to which 
the orifices are dilated, the frequency of the respiratory movements 
and the condition of the muzzle. He may find various eruptions, 
crusts due to discharge, etc., and will remark any peculiarities pre- 
sented by these. The depths of the nasal cavities can only be examined 
through the nostrils to a very limited extent; but the condition of the 
pituitary mucous membrane, its degree of vascularity, and the exist- 
ence of ulcerations or of vegetations can be observed. 

Digital examination is sometimes useful in discovering the condition 
of the lower j)ortions of the turbinated bones. The electric light does 
not greatly assist the observer, on account of the narrowness of the 
air passages. On the other hand, examination of the face, and pal- 
pation and percussion over the region of the frontal sinuses is of 
considerable value. By inspection, one discovers deformity caused by 
tumours, by ossific inflammation, or other lesions ; and detection is 
rendered easier by the fact that deformities are usually asymmetrical, 
only occurring on one side. 

Palpation reveals the degree of resistance and flexibility of the 
external bony wall as well as the condition of the subcutaneous 
tissues. 

Percussion sometimes discloses absolute dulness, due to tumours of 
the mucous- membrane, of the turbinated bones, or of the bones of 
the face. 

The pharyngeal portion of the nasal cavities is difficult to reach, 



812 



RESPIRATORY APPARATUS. 



but can be examined by passing the hand, palm upwards, into the 
pharyngeal cavity, when the fingers may be slipped behind the soft 
palate and thus introduced into the posterior nasal chamber. The 
animals should first be very carefully secured and a strong gag intro- 
duced into the mouth. 

Sinuses. Frontal sinus. — The frontal sinus occupies the greater 
part of the anterior cranial region and the summit of the head, ex- 
tending from the highest point of the poll as far forward as a line 
drawn between the two orbits. Above, it directly communicates with 
the sinus of the horn core. In this upper region, where it abuts on 
the sinus of the ojDposite side along the median line, it is of greatest 




Fig. 163. — Median section through an ox's head. Sf, Frontal sinus; N.Ph. naso- 
pharnyx; Vp., hard palate ; C, turbinated bones ; V., vomer ; L., tongue ; V. pa., 
soft palate ; E., epiglottis ; La., larynx ; OE., oesophagus. 



size. Below, on the other hand, it is very narrow, much broken up 
and incompletely divided into a series of cells, by thin, bony plates 
running in all directions. 

It is in direct communication with the nasal cavity. 

The frontal sinus, then, occupies all the super o-lateral portion of 
the cranial box, which is thus provided with a double wall. At one 
point, however, over a lozenge-shaped area, the cranial cavity is only 
protected by a single wall. It is in this region that the slaughter- 
man strikes the animal when killing it. 

The frontal sinus may be examined by inspection and palpation. 



EXAMINATION OF THE RESPIRATORY APPARATUS. 



313 



Inspection sometimes reveals deformity of the external wall of the 
sinus. Such deformity, however, is rare, and Moussu has only 
observed it in two cases of tuberculosis of the bones forming the 
cranial wall. 

By percussion one detects abnormal sensibility, and partial or com- 
plete dulness over certain areas. 

Maxillarij sinus. — The maxillary sinus occupies the whole lateral 




Fig. 164. — General arrangement of the sinuses. The chcular openmgs mdicate 
points at which trepanation is performed. 



region of the face, from the inferior extremity of the maxillary sj^ine 
as far as the sub-orbito-palatine region. In front its external wall 
is very solid, but behind, below the orbit, is extremely thin. Ex- 
ternally the sinus is largely protected by the anterior insertion of the 
external masseter muscle, a fact which explains how rarely it is 
injured. 

Larynx. In consequence of its deep situation, the larynx can 



.314 



RESPIRATORY APPARATUS. 



scarcely be examined except by inspection, external palpation, internal 
digital palpation, and auscultation. 

External examination presents no difficulty, and enables one to detect 
lesions around or near the larynx. 

Palpation reveals the existence of oedematous swellings, enlarge- 
ments of the retro-pharyngeal lymphatic glands, inflammatory en- 
gorgements, etc. 

Internal digital examination, like examination of the pharynx, can 
only be performed after very firmly fixing the animal in position, and 
inserting a gag in the mouth. 

The hand is introduced, palm downwards, and passed as far as the 




Fig. 165. — Manual examination of the larj^nx in the ox. 

pharyngeal cavity. The index finger can then easily be slipped into 
the glottis. Exploration must be effected rapidly and without violence. 
It reveals the condition of the glottis, the presence, position and form 
of growths like myxomata and of new tissues, due to the presence of 
actinomyces, as well as tuberculous vegetations or ulcerations. 

By auscultation we discover the presence of normal or abnormal 
laryngeal sounds — roaring, whistling, or bubbling sounds, etc. 

Trachea. The trachea may be examined by palpation and 
auscultation. 

Palpation reveals the degree of sensitiveness, abnormalities in position 
or form, the presence of peripheral inflammations, fractures of rings, etc. 

Auscultation indicates whether the tracheal sound be normal or 
otherwise, or accompanied by abnormal sounds, like mucous rales, or 
by pathological sounds conveyed from the chest. 



EXAMINATION OF THE RESPIRATORY APPARATUS. 815 

Thorax. The thorax can be examined by mspection, palpation, 
percussion, and auscultation. 

By inspection ^ve discover whether the formation " of the thorax 
as a T\'hole is normal, or whether there exist congenital or acquired 
deformities, asymmetry like that produced by pneumo-thorax or devia- 
tions of ribs from the normal line, etc. One also notes the breathing 
movements, the manner in which the sides expand and contract, the 
respiratory rhythm, and any special peculiarities of inspiration or 
expiration. 

Palpation reveals the degree of sensitiveness of the thoracic wall and 
of the intercostal spaces, the existence of more or less extensive local 
oedematous infiltration, and the presence or disappearance of thoracic 
conditions like hydro-thorax. 

Percussion indicates the degree of sonority of the chest in different 
parts. It can either be practised directly with the hand or through the 
medium of a pleximeter. The latter method is preferable w^hen 
dealing with fat animals. Percussion, however, gives slightly different 
results, according to the degree of fatness of the subjects. It should be 
practised both in a vertical as well as in a horizontal direction. 

At all points where the muscles are thick or well developed the results 
produced are negative, in the sense that only a dull sound is obtained. 
This is the result obtained in auscultating the areas marked 1, where 
one meets with the ileo-spinal and common intercostal muscle, and in 
that marked i, where the olecranian muscles are encountered (Fig. 166). 
Over the middle and inferior zones, however, the results are much more 
instructive. 

On the right side percussion of the middle zone gives, under normal 
conditions, a clear sound and perfect resonance from above downwards, 
and from in front backwards, between the fourth intercostal space and 
the ninth rib. Beyond this point lies the liver, which gives a partial 
dull sound, and absolute dulness from the ninth to the twelfth rib, in 
consequence of its position, and of the projection of the diaphragm 
towards the thoracic cavity. 

Percussion of the inferior zone produces less marked resonance, w^hich 
diminishes more and more towards the base, in consequence of the thin- 
ness of the pulmonary lobes at this point. This resonance does not 
extend as far as the hypochondriac region, because the lower part of the 
abomasum insinuates itself beneath the costal cartilages and causes a 
region of dulness. 

On the left side percussion gives precisely similar results, except 
in the upper portion of the middle zone. Beyond the ninth inter- 
costal space the sound changes, and has a tympanic character; because 
here the anterior and upper portions of the rumen are encountered, 



316 RESPIRATORY APPARATUS. 

as they are lodged beneath the hypochondrium. Below, the sound is 
dull, on account of the gastric compartments generally being full of 
food. 

Certain trifling modifications of this normal condition may be noted, 
depending on the degree of fatness or thinness of the subjects. The 
pathological changes which may occur are as follows : — 

A tympanic sound, with or without metallic character, may be found 
at a point where normally one would expect a clear sound (pneumo- 
thorax, diaphragmatic hernia). A dull sound may be met with in the 
same regions, all resonance being lost (pneumonia, broncho-pneumonia, 
pleural exudate, etc.). Partial dulness and partial loss of resonance may 
occur in regions which ought to give a resonant sound (deep pneumonia, 
tuberculous lesions, the presence of echinococcus cysts, etc.). 

Auscultation — i.e., examination by means of the ear — is the most 
valuable method of discovering and localising pulmonary, pleural, or 
cardiac lesions. 

Various sensations are conveyed to the ear, depending on the method 
in which the normal or pathological sounds are produced. 

The deductions to be drawn as regards the nature of existing disease 
are based on the intensity, character, duration, and special attributes of 
the sounds noted. 

Direct auscultation is the most certain method, but the ear cannot be 
applied with equal facility at all points. Under such circumstances 
a simple or binaural stethoscope, or the phonendoscope, may be used 
with advantage. 

To properly appreciate the sounds heard it is essential to be exactly 
acquainted with the relation between the lung and thorax. On the left 
side (Fig. 60) the anterior pulmonary lobe occupies the space between 
the first and fourth ribs, in front and above the base of the heart. The 
middle, or cardiac, lobe covers the left upper and postero-lateral part 
of the heart from the fourth to the sixth rib. The posterior lobe 
occupies all the region beyond the sixth rib as far as the twelfth. 

On the right side the arrangement is similar, but the anterior lobe 
and the cardiac lobe are more developed (Fig. 62). 

Under ordinary circumstances the extensive movement of the lung 
which occurs during inspiration produces a special sound known as the 
respiratory or vesicular murmur. Contrary to what has been written 
and said, this sound in animals possessing absolutely sound lungs ends 
with inspiration. Expiration is silent, though it is easy to estimate 
its duration. 

In auscultating the lung, we may distinguish four zones, a superior 
zone, a middle zone, an inferior zone, and a scapular zone. 

The superior zone is bounded by the vertebro- costal gutter, descends 



EXAMINATION OF THE RESPIRATORY APPARATUS. 



817 



approximately as far as the inferior line of insertion of the common 
intercostal muscle, and extends from the summit of the scapula in front 
to the hypochondrium behind. 

Auscultation of this region through the ileo- spinal and common 
intercostal muscle will always reveal, except in very fat animals, the 
vesicular murmur to a point as far back as the eleventh intercostal 
space. Nevertheless, this vesicular murmur is relatively feeble, and 
becomes imperceptible beyond the eleventh rib. 

The middle zone comprises the most convex portion of the ribs, and 
at this point the wall of the thorax is thinnest, while the lung below 
is thickest. 

For these reasons the vesicular murmur is heard at its maximum 




Fig. 166. — The areas over which auscultation of the chest may be performed, 
showing their extent, position and relations to the thoracic wall. 1, Upper 
zone ; 2, middle zone ; 8, inferior zone ; 4, subscapular zone. 



intensity at this point. Towards the upper and lower limits of this zone 
are found the great bronchial divisions, so that auscultation should 
always be practised with the greatest care at this point. The middle 
zone occupies approximately one-third of the total depth of the thorax. 
The vesicular murmur becomes weaker as one passes backwards, and 
finally disappears at a considerable distance from the angle of the 
hypochondrium, following a curved line the convexity of which is 
directed forwards, and which is continuous with that limiting the 
upper zone. 

These peculiarities are due to the anatomical arrangement and 
mode of insertion of the diaphragm on the internal surface of the 
hypochondrium . 



818 RESPIRATORY APPARATUS. 

The inferior zone is very limited, and corresponds externally to the 
inferior third of the thorax, and topographically to the cardiac lobe or 
middle lobe of the Imig and to the inferior portion of the posterior lobe. 

As these pulmonary lobes are of comparatively slight thickness, the 
vesicular murmur is feeble. It can be heard over a trapezoidal space, 
forming a prolongation of the middle zone, but not below in the region 
of the sternum or pectoral muscles. 

The fourth zone extends over the mass of the olecranian muscles. 
It is of triangular form, in consequence of the inclination of the scapula 
and humerus. Except in very fat animals the vesicular murmur is 
readily audible through the muscular mass on the right side better than 
on the left, on account of the development of the right anterior pul- 
monary lobe. 

On the left side the beating of the heart is heard above the 
pulmonary sounds. 

Clinically one may hear an exaggeration of the ordinary respiratory 
murmur whenever the lung is actively exercised, as, e.g., immediately 
after trotting. This exaggeration, however, is often pathological. It is 
know^n as " juvenile or supplementary respiration," when due to the 
fact that some other portion of the lung is not acting. 

The respiratory murmur may be lessened in certain morbid con- 
ditions, such as 'emphysema and congestion of the lung, and may com- 
pletely disappear in pneumonia or broncho-pneumonia, a fact which 
is even of greater significance. 

In various pathological conditions the respiratory murmur may also 
be modified. On the other hand, the movement of air in the bronchi 
also produces various sounds of importance. 

A number of different bronchial sounds may be distinguished; these 
include both inspiratory and exj)iratory sounds, for sometimes an ex- 
piratory sound may become audible and clearly appreciable, or may 
acquire characters of the greatest importance. 

The inspiratory sound may be strong, rough, rasping, painful, moist 
or rattling. The pathological expiratory sounds may vary between 
audible, strong, rough, prolonged, or rattling. The varieties of soufile, 
or rattle, are the tubal souffle of inspiration or expiration (met with 
in pneumonia or broncho-pneumonia) ; the soft, deep-seated pleuritic 
souffle (peripneumonia) ; the continuous cavernous souffle (met with in 
tuberculosis) ; the broad amphoric souffle, in which the vibrations are 
extensive and of metallic character (met with in pneumo-thorax). 

As to the varieties of rfdes which usually accompany these souffles, 
they may all be met with in tuberculous animals, and comprise 
crepitant and sub-crepitant, mucous, cavernous, snoring and sibilant 
rales. 



CHAPTER II. 

NASAL CAVITIES. 

SIMPLE CORYZA. 

Simple acute coryza, or inflammation of the mucous membrane 
of the nasal cavities, is of comparatively trifling importance in bovine 
animals, and, ^Yere it not for the possibility of gangrenous coryza being 
confused with it, there would scarcely be any necessity for a special 
description. 

The onset of coryza is indicated by repeated sneezing and coughing, 
by congestion of the pituitary mucous membrane, which soon begins to 
secrete abnormally, and by difficulty in respiration, which becomes 
snoring or whistling. 

The discharge, transparent at first, then mucous and muco-purulent, 
is abundant in quantity ; the inflammation is arrested at this point or 
extends towards the facial sinuses, the pharynx and larynx ; the eyes are 
swollen and watering, and almost all the characteristic symptoms appear 
which mark the onset of gangrenous coryza. Two signs, however, are 
wanting. The appetite is fairly well maintained, and the temperature 
little above normal. Simple coryza occurs at all times of the year in 
consequence of sudden chills, but is commonest in sj)ring and autumn. 

At first the distinction between this condition and gangrenous coryza 
can only be ascertained after taking the temperature. 

The prognosis is absolutely favourable, and often in forty-eight 
hours every symptom disappears. 

Treatment is confined to keeping the animals in stables at a suit- 
able temperature, sheltered from draughts. Emollient fumigations and 
inhalations of turpentine, creosote, or eucalyptus oil rapidly check the 
more alarming symptoms. Warm drinks and foods and cooked roots 
are recommended. 

In sheep, acute coryza as a consequence of chills, etc., occurs in 
autumn, but is more commonly due to a parasitic cause, viz., invasion 
of the nasal cavities by larvae of certain oestridse. During the succeeding 
winter it continues under the form of chronic coryza, as a result of the 
larvai retaining their position in the sinuses. 



320 NASAL CAVITIES. 

Treatment of this parasitic coryza consists in trephining the sinuses 
and destroying the larvge. 

GANGRENOUS CORYZA. 

Gangrenous coryza is a grave disease of diphtheritic character, which 
at first seems to be localised in the mucous membrane of the upper 
respiratory passages, but which exhibits a tendency to affect all the 
mucous membranes of the system. 

The term "gangrenous coryza," adopted in France, has been re- 
placed in other countries, especially in Germany, by such descriptions as 
" contagious disease of the head," and "malignant catarrhal fever of the 
ox." Old writers describe gangrenous coryza as a disease common in the 
Jura, the eastern parts of France generally, and in the valley of the 
Saone. In reality this disease occurs everywhere, both in the centre, 
west and north of France, as well as in the eastern regions. Serious 
outbreaks frequently occur in Germany and Italy. 

Symptoms. Gangrenous coryza assumes three different forms, which, 
however, only represent successive degrees of intensity of the attack. 
In the peracute form death occurs in three to five days, even when the 
characteristic signs are not all as yet apparent. In the acute, and by 
far the most frequent form, the disease lasts from fifteen to twenty days, 
and also ends in death in by far the greater number of cases. Finally, 
in the form usually termed chronic, the disease lasts from four to eight 
weeks, and most frequently ends in recovery. 

Acute and ])erac'ute forms. — The onset is marked by very striking 
symptoms, which precede the local symptoms by some hours, or by a 
day or more. 

The temperature rises rapidly from the normal to 103° or 105° 
Fahr. (39*5° to 41° C), or even higher. Appetite and rumination are 
entirely suspended; the respiration becomes rapid and difficult, while 
the heart beats strongly and tumultuously ; the muzzle is dry, the 
mouth hot, and salivation so abundant as to suggest an attack of foot- 
and-mouth disease. Fseces and urine are only 23assed at long intervals, 
and dysuria is present. 

At first everything seems to indicate the development of an acute 
infectious disease ; but soon afterwards appear local indications affect- 
ing the respiratory, ocular, digestive, urinary, nervous and cutaneous 
systems. 

The respiratory symptoms are most important, and almost charac- 
teristic. Eespiration becomes difiicult, rough as in acute coryza, but 
soon assumes a snoring character, and is accompanied by a discharge, 
containing false membranes, from both nostrils. 

The serous and muco-purulent discharge becomes rusty or reddish- 



GANGRENOUS CORYZA. 321 

brown, soon acquires a very foetid smell, and is found to contain epithe- 
lial debris and yellowish-green false membranes. After the least effort 
to cough or the slightest touch on the membranes themselves — some- 
times without any visible cause at all — epistaxis sets in, the blood being 
mixed with the discharge or simply escaping in the form of reddish 
strings, like that occasionally seen in glanders. 

The mucous membrane of the nasal cavities is red, turgid, apt to 
bleed, and painful to the touch. 

Percussion of the nasal cavities, sinuses, and even of the horns reveals 
everywhere exceptional sensibility. 

Sometimes, but only in certain subjects, the lower portions of the head, 
including the muzzle, nostrils, lips and forehead, become infiltrated, as 
though the case w^ere one of purpura. Thoracic complications are rarely 
absent, unless the disease is treated. Towards the end of the first w^eek 
the respiration, still painful and snoring, becomes more rapid ; and 
auscultation reveals at various points in the lungs areas of bronchitis 
and of broncho-pneumonia, indicated by bronchial rales, rattling breathing, 
and tubal souffles, etc. These complications are accompanied by attacks 
of coughing, which increase the discharge, and may threaten to end in 
suffocation. This happens when large masses of false membranes from 
the bronchi are thrown into the larynx and cannot readily be ejected 
through the glottis, which has been reduced in size by oedematous 
infiltration and inflammation. 

Percussion is generally useless. The appearance of the eyes is also very 
significant. These symptoms develop simultaneously with the respiratory 
disturbance, and are marked by infiltration of the eyelids, oedematous 
conjunctivitis, and ophthalmia. The cornea becomes whitish, infiltrated, 
opaque, and sometimes shows ulcerative keratitis ; or, on the other hand, 
it remains simply semi-transparent, and through it the media of the 
eye may be seen to have become opalescent. Ulcerative keratitis may 
develop rapidly and end in perforation of the cornea. 

In certain rare instances examination with the ophthalmoscope has 
revealed the existence of exudative iritis ; this condition may be com- 
plicated with s^aicchia, intra-ocular haemorrhage, and result in perma- 
nent loss of vision. 

These ocular symptoms are accompanied by continuous, abundant 
and prolonged discharge of tears, intense photophobia, and exceptional 
sensitiveness to manual examination, etc. 

Digestive disturbance appears less important, and may be regarded as 
consequent on the febrile reaction, the general disturbance, or the condi- 
tion of the respiratory apparatus. But complete examination will show 
that from the onset of the disease a special form of stomatitis occurs. 
Prom the first the mouth is hot and dry : soon afterwards abundant 

D.C. Y 



322 NASAL CAVITIES. 

reflex salivation occurs, and the discharge, like that from the nose, becomes 
excessively foetid. This stomatitis differs entirely from ordinary forms 
of stomatitis and from the stomatitis peculiar to foot-and-mouth disease, 
and is characterised by the necrosis of fragments of epithelium forming 
false membranes. These on being shed leave exposed numerous ulcers 
distributed over the tongue, cheeks, and lips. Neither vesicles nor pus- 
tules are produced, but merely false membranes of small dimensions. 

The false membranes and ulcerations occur on the soft palate and in 
the pharynx. 

"When the patients survive for a certain time, croupal enteritis and 
ulcerative enteritis, sometimes accompanied by haemorrhage, develop. 
The administration of enemata is followed by the passage of faeces con- 
taining considerable fragments of epithelium or of streaks of blood. 
From the outset these digestive complications are indicated by failure to 
ruminate, by cessation of peristalsis and by constipation, which is usually 
succeeded by abundant foetid diarrhoea. 

Functional disturbance of the genito-urinary apparatus is rarer, or 
at least more difficult to detect. The animals refuse drink ; micturition 
seems to be suspended or very difficult. The urine may be albuminous 
or rose-coloured, in consequence of the presence of heematin ; more rarely 
it is purulent or sanguinolent. There may also be urethritis, cystitis, 
pyelitis, and nephritis, with the passage of hyalin cylinders in the urine, 
although this is not always the case. 

In females the mucous membrane of the vagina and lips of the vulva 
usually seem congested and oedematous ; but it is rare to find diph- 
theritic false membranes, as on the buccal and nasal mucous membranes, 
etc. On the other hand, vaginitis and exudative metritis are common. 

Cutaneous outbreaks also constitute important symj)toms by which 
this disease is recognised. At points where the skin is fine, on the 
inner surface of the thighs, around the girth, on the inner surface of 
the forearm, and on the mammae, etc., an exanthematous eruption 
occurs, followed later by the development of pustules, which at first 
sight might suggest cow-pox. 

These pustules are prominently apparent, and can readily be detected 
on palpation. They are more or less confluent, hard, and without a 
peripheral oedematous zone. 

In the case of the mammae these pustules occur most commonly on 
the teats, are round or slightly oval in form, bright red in colour, and 
sometimes violet-red. They never become converted into vesico-pustules, 
as in cow-pox, or into vesicles ; and in no way resemble the skin eruption 
peculiar to foot-and-mouth disease. 

Certain nervous symptoms have also been described, comprising 
trembling, eiDileptiform convulsions, and paraplegia of the hind quarters. 



GANGRENOUS CORYZA. 323 

MoussiT has never seen nervous disturbance assume the form of 
epileptiform convulsions, and it is possible that the paraplegia referred 
to simply marks the last stage of the disease. 

Causation. The essential cause of gangrenous coryza has not yet 
been definitely ascertained. Within recent years teachers of the highest 
authority have represented the disease as a general affection belonging to 
the haemorrhagic forms of septicaemia (Nocard and Leclainche). Nocard 
has found ovoid bacteria in the false membranes of the larynx, and 
Leclainche a paracoli-bacillus in the mesenteric ganglia and the intes- 
tines, but the disease has never been reproduced in a characteristic and 
complete form similar to the clinical type. 

Other microbes have also been described as occurring in the blood or 
discharges ; but attempts to transmit the disease by using cultures or the 
different morbid products which observers have collected have invariably 
failed, and it has therefore been concluded that the disease is not 
contagious, but merely infectious. 

Moussu does not regard this disease as a haemorrhagic septicemia, 
because the blood proves sterile unless grave pulmonary, intestinal or 
renal complications occur, and because the disease appears capable of 
being cured in a short time by simple methods. In the present state of 
knowledge he prefers to regard it as an infectious disease of diphtheritic 
form, at first localised in the upper respiratory and digestive tracts, 
always tending towards a grave toxaemia, and towards complications due 
to various other infections. 

Even though direct contagion has not been proved, it is impossible 
to doubt that stables may become infected. This is sufficiently proved 
by the continued appearance of the disease when disinfection is neglected 
after the occurrence of the first case. 

It is possible that the causes formerly assigned — viz., chills, the 
influence of draughts, and a morbid predisposition — may increase sus- 
ceptibility in animals otherwise well cared for, but it is quite certain 
that infection of the stable is an important factor. 

Lesions. The lesions vary with the complications, but those shown 
in the beginning are always identical. The mucous membrane of the 
nasal cavities is congested, inflamed, sphacelated, and ulcerated at dif- 
ferent points. The turbinated bones and the ethmoid cells may become 
necrotic ; in the larynx the region of the glottis is always most markedly 
affected ; the mucous membrane becomes ulcerated in the neighbourhood 
of the vocal cords, and the tissues may become more deeply attacked. 

In the trachea and bronchi the mucous membrane undergoes desqua- 
mation, and may become ulcerated at the points where false membranes 
have formed. The mucous membrane of the sinuses is always affected, 
but is rarely ulcerated. 

Y 2 



324 NASAL CAVITIES. 

Such complications as capillary bronchitis, broncho-pneumonia, and 
gangrene of the lung may be noted. 

The mucous membrane of the mouth presents a violet-red or 
blackish-red colour ; the tongue and gums are swollen, and ulcers 
as large as a lentil or a halfpenny may occur either singly or in a 
confluent form. 

The genito-urinary apparatus reveals signs of croupal cystitis, 
submucous effusions of blood, vaginitis with the formation of false 
membranes, acute pyelitis, etc. 

Diagnosis. When the symptoms are fully developed the diagnosis of 
gangrenous coryza is extremely simple, but the absence of some of these 
may justify hesitation in forming an opinion. If the examination is 
carefully carried out, it is always possible to distinguish this disease 
from simple coryza, which is only accompanied by trifling fever, and in 
which appetite is preserved ; from foot-and-mouth disease, with its very 
characteristic buccal eruption and absence of lesions from the upper 
portions of the respiratory tract ; and from contagious ophthalmia. 

Prognosis. Up to the present time the prognosis has always been 
regarded as extremely grave, the mortality being sometimes as high as 
from 90 to 100 per cent., and moreover the cases which recover are 
invariably those of what is considered the chronic form. Sudden 
sinking of temperature during the disease is an unfavourable sign. 
From 1894 to 1900 Moussu never cured a single case, w^hatever his 
method of treatment ; nevertheless, it now seems possible to regard the 
condition a little more hopefully, provided that no incurable compli- 
cation occurs before the beginning of treatment. 

Treatment. Of all the modes of treatment suggested — viz., anti- 
febrile agents, general stimulants, purgatives, diuretics, external 
stimulant applications, etc. — none have succeeded. Antiseptics in- 
jected into the nasal cavities, antiseptics given internally, milk diet, 
and all the methods hitherto suggested are equally useless. 

The only treatment which appears to have achieved any degree of 
success is that of injecting physiological salt solution in large doses (up 
to six quarts per day, divided into three parts). All the animals treated 
by this method recovered, provided they presented no broncho-pulmonary 
complications. 

The sole inconvenience of this treatment is the difficulty in carrying 
it out when the animals are at a distance from the practitioner. It is 
indispensable that they should be close at hand, in order that he himself 
may make the injections at the proper time. There is some reason for 
hoping, however, that serum from animals which have recovered will 
prove to be more active than saline injections. 

This method of treatment should be followed up by the most rigid 



TUMOURS OF THE NASAL CAVITIES. 



325 



hygienic precautions. The mouth, nasal cavities and eyes should fre- 
quently be washed with antiseptic solutions. The stables should be freely 
ventilated, and the floors and bed kept in the cleanest possible condi- 
tion, etc. 

Whenever a case of gangrenous coryza is observed it should be 
isolated, and the stables should most carefully be disinfected. 

TUMOURS OF THE NASAL CAVITIES. 

Apart from actinomycosis of the upper jaw, tumours of the nasal 
cavities or of the sinuses are not frequent in bovine animals. They are, 
however, occasionally met with, and present symptoms which must be 




Fig. 167. — Transverse section through the nasal cavities near 
their centre (normal). 

carefully studied in order to avoid errors of diagnosis. Usually they 
are of the nature of myxomata, more rarely of fibro-myxomata. 

Symptoms. T^he dominant symptom is difficulty in breathing, both 
w^hen moving and eating, a difficulty which is sometimes so considerable 
as to cause snoring respiration or roaring. Nevertheless, examination of 
the trachea and of the lung, visual examination of the lower portions of 
the nasal cavities, and manual examination of the pharynx, larynx and 
glottis give only negative results. It may even happen, as occurred in 
the case from which the illustration herewith was taken, that percussion 
of the maxillary sinus reveals normal resonance. 

In the case of tumours of small size the forehead is not deformed. 
When, on the other hand, the tumour partly obstructs the nasal cavities it 



326 



:S^ASAL CAVITIES. 



may thrust on one side the septum nasi and externally cause well-marked 
asymmetry of the face. Sero-mucous or muco-purulent discharge then 
occurs. 

The diagnosis is somewhat difficult, for continuous or temporary 
roaring (or at any rate difficulty of respiration), heing the dominant 
symptom, must he distinguished from roaring due to a laryngeal lesion 
like paralysis or tumour formation, from perilaryngeal compression due 
to enlarged retropharyngeal glands, and from tracheal or pulmonary 
lesions ; and its origin must he located in the nasal cavities. 




Fig. 168. — Transverse section through the nasal cavities : myxoma of the right 
side and of the maxillary sinus. Deformity of the forehead and face. 

The prognosis is grave, in consequence of the difficulty of exploring 
the depth of these cavities and of the possible nature of the tumour. 
Nevertheless, in the case of simple myxomata permanent recovery 
usually follows extirpation. 

Treatment is confined to extirpation, which is quite possible in the 
case of pedunculated tumours ; in the case of sessile tumours free 
trepanation of the roof of the nasal cavities becomes necessary. The 
operation is quite safe. 

PURULENT COLLECTIONS IN THE NASAL SINUSES. NASAL GLEET. 

From the clinical point of view two varieties of this condition may be 

distinguished — inflammation of the mucous membrane of the maxillary 



PURULENT COLLECTIONS IN THE FRONTAL SINUS. 327 

sinus and inflammation of the mucous membrane of the frontal sinus 
and of the horn core. These forms of inflammation frequently lead to 
suppuration. The jdus collects in the depressions and divisions of the 
frontal or maxillary sinus. 

PURULENT COLLECTIONS IN THE FRONTAL SINUS. 

Causation. In the majority of cases inflammation of the mucous 
membrane of the frontal smus is produced by external causes : fractures 
of the horns and horn core accompanied by hsemorrhage into the horn 
core ; fractures of the horn ^ith exposure of the sinus of the horn core ; 
womids and violent blows on the occipital region or the frontal bone ; 
cracks or depressions of the external wall of the sinus, etc. 

In all these cases, whether blood is eft\ised or the mucous membrane 
of the sinus is merely infiltrated with serum, infection may be produced 
by germs being deposited from the air passing through the nasal cavities 
and causing suj^puration. 

Purulent collections m the frontal sinus may result from continued 
irritation, like that due to a badly fitting yoke. They also occur as an 
accidental complication of general diseases like gangrenous coryza. 

Symptoms. The catarrh or purulent collection in the sinus may be 
unilateral or bilateral, and the symptoms vary, according to the form 
which it assumes. 

Unilateral collections. — Xasal haemorrhage is often the first symptom, 
but this is often regarded as of little importance, because the formation of 
pus does not occur until very much later. The animal shows ill-defined 
pain, loses appetite, remains dull and somnolent, and carries its head on 
one side. The horn on the injured side is hot and sensitive, and at a 
later stage the eye becomes afi'ected by contiguity of tissue. It is then 
swollen, closed, and watery; the conjunctiva is infiltrated, and somewhat 
inflamed. Sensibility and partial or complete dulness of the afi'ected 
side may be detected by palpation and percussion. On the animal 
being made to cough, a yellowish or greyish- white discharge of very 
foetid and sometimes putrid character escapes. 

Bilateral collections. — Catarrh is rarely bilateral at first ; but if the 
unilateral lesion is not treated, it affects the median septum di\iding the 
two canities, and the inflammation extends to the second sinus. The 
animal then shows dull pain, and exhibits marked depression ; sometimes 
it appears quite j)rostrate. The head is carried low and inclined towards 
the ground, while the above-mentioned ocular symptoms and the indi- 
cations furnished by palpation and percussion extend to both sides. 
Coughing produces momentarily a double discharge, which the animal 
disposes of after the fashion of horned cattle. 



328 NASAL CAVITIES. 

Diagnosis. The diagnosis only presents difficulty in the early stages. 
Later the warmth and sensitiveness of the horns, the partial dulness, 
offensive character of the discharge, etc., render diagnosis easy. 

The disease is not likely to be mistaken for gangrenous coryza, 
despite the condition of the eyes, because it develops slowly, progres- 
sively, and without marked fever. 

Prognosis. If treated early, unilateral or bilateral collections of pus 
in the sinuses are capable of cure, but later when bodily health is im- 
paired and the local lesions of the mucous membrane very pronounced, 
there is less chance of success. 

Lesions. The initial lesions consist in cracks, fissures, or fractures 
of the bones of the face or exostoses of traumatic origin. In other cases 
the mucous membrane alone is affected. As a result of chronic irrita- 
tion it becomes thickened, inflamed, and ulcerated, and granulates 
freely. The depressions in the sinuses contain grumous, foetid pus, 
which irritates the surrounding tissues and produces pain and general 
symptoms of cerebral irritation, which are sometimes very disquieting. 

Treatment. Numerous methods of treatment were formerly recom- 
mended, such as absolute rest, bleeding, cold affusions, perforation of a 
horn, section of a horn, etc. None of these is of any value. 

At first, provided only a certain degree of sensitiveness and simple 
catarrh witliout suppuration exist, antiseptic fumigations with tar, car- 
bolic acid, thymol, etc., are useful ; but later, when pus has formed, 
they are useless. At this period the only rational and efficacious treat- 
ment consists in trepanation. In unilateral collections three openings 
are necessary. 

The first is an opening into the sinus of the horn core. It is made 
I to f of an inch above the horn -secreting band of the horn. It must 
not be forgotten, however, in planning such an opening that the sinus of 
the horn core only exists in a rudimentary condition in young animals, 
and that it is scarcely possible to trephine the horns before the patient 
is three years of age. 

The second opening is made towards the upper part of the frontal 
sinus about f inch below the horn-secreting ring at the base of the 
horn and in a line with the axis of the horn core itself. Whatever the 
animal's age and however little the sinuses may be developed, this 
opening is certain to expose the cavity of the frontal sinus. 

In old animals where the frontal sinus is enormously developed, and 
where very large depressions exist in the orbital region, a third opening 
should be made just above a transverse line uniting the upper margins 
of the two orbits and inside the suborbital suture. 

These openings having been made, treatment consists — firstly, in 
completely washing out the cavity with boiled water, cooled to 95° or 



PURULENT COLLECTIONS IN THE MAXILLARY SINUS. 329 

100° Fahr. ; and, secondly, in injecting antiseptic and astringent solutions 
so as to check the formation of pus. ximong such may be mentioned 
3 per cent, carbolic solution, 5 per cent, carbolic gi3^cerine, 2 per cent, 
solution of iodine in iodide of potassium, etc. 

Whatever the drugs employed, the cavities should be washed out 
every day, first with plain sterilised water, and then with antiseptic 
solutions at the body temperature, since cold solutions often cause 
inflammation of the mucous membrane of the opposite sinus. 

PURULENT COLLECTIONS IN THE MAXILLARY SINUS. 

This disease is much rarer than that of the frontal sinus, and only 
within the last few years (Eies, 1899) has a really good description been 
given of it. 

The causation is imperfectly understood. Injuries to the suborbital 
region and maxillary ridge, caries of the molar teeth, and inflammation 
occurring during the development of general diseases represent the 
princijjal causes. 

The dominating and characteristic symptom of the presence of pus 
in the maxillary sinus consists in incessant snorting, accompanied by 
violent movements of the head and the discharge of purulent or muco- 
purulent material. 

At the beginning of these attacks of snorting, which are produced 
by the reflux of pus from the sinus towards the nasal cavities, the 
respiration becomes snoring and rapid, and the animal makes snifling 
movements as though the nasal cavities were partially obstructed. jVfter 
these crises, the respiration again becomes silent. 

Contrary to what has been observed in purulent collections in the 
frontal sinus, the discharge is unilateral, reddish yellow in colour, 
viscous in consistence, and is accompanied by clots of a gelatinous 
material or even of blood. 

During the attacks of snorting, the discharge resembles that of 
croupal or pseudo-membranous bronchitis, but the material discharged 
is not moulded on the internal shape of the bronchi. The masses of 
discharge are irregular in form, and appear as though made up of fibrous 
tissue matted together. Attention having been attracted by the dis- 
charge, exploration of the trachea and chest reveals nothing ; on an 
examination of the sinuses, however, palpation and percussion betray 
a certain amount of sensitiveness, together with partial or complete 
dulness, and the lesion is discovered. 

Diagnosis. Confusion between pus formation in the maxillary and 
frontal sinuses can be avoided by careful examination. 

Prognosis. The prognosis is not very grave ; the animals maintain 



330 NASAL CAVITIES. 

their appetite, but become thinner, and the condition shows no tendency 
to spontaneous cure. 

Treatment. The only rational treatment consists in trephining, an 
operation practised immediately above the maxillary tuberosity and over 
the lowest part of the sinus (Fig. 164). This opening allows the cavity 
to be washed out and the sinus drained. 

Antiseptic treatment exactly resembles that of purulent collections 
in the frontal sinus. Injections of astringents, dilute carbolic acid and 
iodine solutions, etc., are recommended. 

CESTRUS LARVM IN THE FACIAL SINUSES OF SHEEP. 

(false sturdy.) 

Causation. This disease of sheep, w^hich sometimes produces vertigo 
resembling that shown in gid or sturdy, is produced by the growth of 
larva3 of Gilstnis oris in the frontal sinuses. The oestrus of the sheep 
assumes perfect insect form during the fine days of summer from July to 
September. The females swarm around the flocks and attempt to alight 
on the animal's head close to the nostrils, where they deposit their eggs 
or larvae. The larvae crawl into the nostrils, thence into the nasal cavities, 
the meatus, and finally the sinuses, where they become fixed. In these 
sinuses they undergo complete development, increasing from a length of 
about Yo ii^c^ ^0 from f to 1 inch before their transformation into the 
nymph and perfect insect. They remain in the sinus for eight to ten 
months. When numerous and well developed they may fill the whole 
of the cavity. 

Symptoms. It is easy for a careful observer to note the time at 
which the larvae penetrate the sinus. During the hottest hours of the 
day the adult insects are continually hovering over the flocks, and on 
watching carefully one sees sheep suddenly become excited, tap with their 
feet, rub their faces against any hard, resisting object in the neighbour- 
hood, plunge their nostrils into the dust, and snort violently. 

When the larvae have penetrated the nasal cavities they produce 
frequent attacks of sneezing by irritating the mucous membrane, and 
cause an intense sero-mucous and afterwards a moderate muco-purulent 
coryza. As long as the larvae remain of small size, the apparent results 
they produce are insignificant, as during the first months of winter ; but 
when they are numerous, and have become of considerable size, they 
cause symptoms which might suggest an attack of gid or sturdy. 

Thus the bodily movements become spasmodic, the gait irregular, 
and the animals show attacks of vertigo. They stagger and fall, making 
convulsing movements, grinding their teeth and rolling their eyes, while 
frothy saliva escapes from the mouth, etc. 



(ESTRIJS LARVJ^ IN THE FACIAL SINUSES OF SHEEP. 



331 



Death may occur during such attacks, which, however, are happily 
very rare. Most commonly the animals are simply dull and somnolent. 
They feed badly, carry their heads low, and sometimes hide themselves 
under the mangers or in corners. 

In exceptional circumstances they bury their heads in the wool or 
carry them high in the air in walking, w^hile they lift their front legs 
high, with a stepping movement. 

Diagnosis. The diagnosis of parasitic invasion of the sinus in the 




^:^'r 



Fig. 169. — Parasitic invasion of the sinuses and coenurosis (showing the 
seat of operation in eitlier condition). 



sheep is rather difficult, because certain of the symptoms suggest gid. 
One never finds the signs of true gid, however, and, on the other hand, a 
certain amount of discharge and attacks of snorting ahvays exist. Finally, 
gid (coenurosis) only attacks young animals, whilst the larvae of oestridse 
are commonest in adults. 

To confound the disease with verminous bronchitis is still less likely, 
for although a discharge exists in both cases, this is accompanied by 
cough in bronchitis, and only by sneezing attacks in infection of the 
sinuses. 



332 NASA.L CAVITIES. 

Finally, in bronchitis, histological examination leads to the discovery of 
eggs or embryos of the strongyles. The diagnosis becomes very easy on 
post-mortem examination, the identification of the larvae of oestridae being 
extremely simple. 

Prognosis. The prognosis is only grave when infestation is very 
pronounced. Most commonly the parasites complete their development 
without producing disquieting symptoms ; as summer approaches they 
are expelled and recovery occurs. 

Lesions. The only lesions consist in very active inflammation of the 
mucous membrane of the sinus, which appears excessively hypertrophied, 
and in the existence of larvae. These develop in the midst of a magma of 
purulent, foetid discharge. The number of parasites usually ranges from 
two to twenty, although Ziirn declares that he has found as many as 
eighty in one subject. 

Treatment. Many precautions have been suggested for preventing 
infestation. Many are impossible or difficult to carry out in current 
practice, even the soaking of the nostrils in empyreumatic oil, and the 
majority are useless. The only suggestion to which we attribute any 
importance consists in trying to prevent the perfect insects from obtain- 
ing a lodgment in cavities in the walls or roofs of sheep-sheds. 

The really efficacious modes of treatment are also few in number, for 
the larvae are so firmly lodged in the mucous membrane of the sinuses that 
they can only be detached after these have been trephined. The use of 
nasal injections, embrocations and powders, with the object of making 
the animal sneeze, are ineffectual. 

Trepanation should not be performed until it is quite clear that the 
flock is badly infested, and when serious symptoms appear to threaten 
the lives of some of the animals. 

The operation, although very simple, requires care on account of the 
thinness of the bones. 

The anatomical directions are the middle line of the head, and a 
transverse line uniting the upper margin of the two orbits. The orifices 
are made in the two lower angles produced by the intersection of these 
lines (Fig. 169). 

It is then easy to remove with the fingers or forceps the larvae situated 
immediately below the point of trepanation, and afterwards to wash out 
thoroughly the cavities of the sinuses. If some lie at points which cannot 
be directly reached, they can be killed by injecting a little benzine and 
water. This proceeding is quite safe. 



CHAPTER III. 

Larynx, trachea and bronchl 

LARYNGITIS. 

Laryngeal diseases are common, but are usually only the local expres- 
sion of some grave general infection, such as foot-and-mouth disease, 
gangrenous coryza, or tuberculosis. Pathological conditions such as these 
can be disregarded for the moment, as they will receive attention under 
special heads. 

The two current forms of laryngeal disease are acute lar^^ngitis and 
stridulous laryngitis. 

ACUTE LARYNGITIS. 

Acute laryngitis, like simple coryza, of which it is often only an 
accompaniment, is caused by chill, by irritant vapours, by smoke, etc., 
or by external traumatic causes. 

The cough is dry and painful at first ; afterwards it is accompanied 
by a discharge or by the swallowing of mucus or muco-purulent products. 
The respiration sometimes appears accelerated and difficult, but roaring 
or whistling and marked fever are rare. The slightest pressure over the 
laryngeal region causes pain and attacks of coughing. The respiration 
is normal while the animal is at rest, provided that the laryngitis remains 
localised ; frequently, however, it is complicated with bronchitis. 

The appetite is somewhat diminished, but all these symptoms very 
rapidly improve. 

The diagnosis is based on the frequency of the cough and the sensi- 
tiveness of the throat region. 

The prognosis is favourable in cases of simple laryngitis. 

Treatment consists in the administration of steam inhalations, 
warm drinks, the application of mustard plasters or blisters around 
the laryngeal region, and the administration of expectorants to facili- 
tate mucous discharge. 

PSEUDO-MEMBRANOUS LARYNGITIS. 

Pseudo-membranous laryngitis, also termed by German authors 
croupal or diphtheritic laryngitis, because it bears a certain resemblance 



334 LAEYNX, TEACHEA AND BEONCHI. 

to human croup, is characterised by the formation of false membranes 
on the vocal cords, arytenoid cartilages, and subglottal region, etc. 

In France it has been described under the name of stridulous 
laryngitis, because its dominant symptom consists in attacks of intense 
dyspnoea, during which the respiration is accompanied by whistling. 
Without making any attempt to prejudge the nature of the disease, which 
resembles the pseudo- diphtheritic forms of laryngitis in man, we prefer 
the term pseudo-membranous laryngitis. Moreover, this pseudo-mem- 
branous laryngitis very frequently accompanies pseudo-membranous sore 
throat, tracheitis and bronchitis, with formation of false membranes. 

Causation. The causes suggested are similar to those of simple sore 
throat : they include chills, the ingestion of ice-cold water, or the inhala- 
tion of irritant gases, during outbreaks of fire, etc., etc. ; but it is quite 
certain that here, as in many similar cases, a primarily simple laryngitis 
is complicated by a well-marked infection. 

Symptoms. The general symptoms seen during the early stages 
consist in loss of appetite, general depression, rigors, and a rise in 
temperature of 1° to 2° Fahr. 

Then, after twenty-four or forty-eight hours, the respiration becomes 
more rapid, difficult, whistling and dyspnoeic, with intermittent attacks 
of suffocation. 

Examination of the chest gives negative results, but, on the throat 
being manipulated, the slightest pressure exercised over the larynx pro- 
duces attacks of coughing. During the first few days these attacks are 
loud, spasmodic, and difficult, but on succeeding days they lead to the 
discharge, from the nostrils or mouth, of masses of false membrane 
accompanied by whitish and sometimes blood-stained fluid. Secondarily 
the mucous membrane of the nasal fossse appears inflamed to a varying 
degree. The conjunctiva is also affected, the eyes are watering. An 
important symptom consists in the fact that this watering is accom- 
panied by internal ophthalmia, as in gangrenous coryza. 

In consequence of the respiratory difficulty, the animal takes up a 
characteristic attitude, holding its neck stiffiy in a horizontal position 
and its head completely extended ; the nostrils are widely dilated. 
When the disease is fully developed rumination is suppressed, the 
bowels are constipated and the faeces are coated as in grave cases of 
enteritis, the yield of milk diminishes, the heart beats feebly, the pulse 
remains small ; death may occur from asphyxia, and probably also from 
intoxication. 

The disease usually lasts from eight to ten days, but death may occur 
earlier. In the majority of cases, however, the animal can be saved. 
All the symjDtoms diminish, the temperature falls, rumination again 
appears and with it appetite, and the whole condition becomes normal. 



TUMOURS OF THE LAEYNX. 335 

Many animals, however, remain thin and recover slowly ; these 
are principally cases which have suffered from pseudo-membranous 
bronchitis. 

Lesions. The lesions may be confined to the larynx, but may also 
invade neighbouring cavities. They consist in the formation of muco- 
albuminous and fibrinous exudates, covering the mucous membrane in 
superposed layers, penetrating the epithelial stratum, and adhering so 
strongly to the corium that attempts to loosen them cause the deeper 
seated structures to bleed. 

Diagnosis. The symptoms are sufficiently well marked to prevent 
any confusion arising except with gangrenous coryza, but in this case 
there is no ophthalmia lesion of the nasal cavities, cutaneous eruption, 
or eruption over the claws. 

The prognosis is grave when the disease attacks debilitated or 
exhausted animals. 

The treatment is confined entirely to treating symptoms. As in all 
acute inflammatory affections, moderate bleeding, sinapisms over the 
region of the larynx, repeated as often as necessary, or applications of 
antimonial ointment have been recommended. Applications of moxas 
or setons in the neighbourhood of the dewlap might possibly prove of 
value. 

Internally tartar emetic, in doses proportioned to the size of the 
animal (2| to 3 drachms in adults), has been recommended; also iodide 
of potassium. 

General stimulants, like alcohol, coffee, tea, acetate of ammonia, and 
suitable hygienic conditions suggest themselves. Tepid drinks can be 
given freely. Nourishing and easily digested food, and a ration of milk 
com]3lete the treatment. 

Emollient and antiseptic fumigations are also of value, as in ordinary 
sore throat or laryngitis, for they favour the separation and discharge 
of the false membranes. 

TUMOURS OF THE LARYNX. 

Acute forms of pseudo-membranous laryngitis, or even tuberculous 
laryngitis, are not the only diseases which affect the larynx. It is by no 
means exceptional to discover intra-laryngeal tumours, mucous polypi, 
tuberculomes, and growths due to actinomyces, etc. 

The presence of these tumours is indicated by difficulty in respira- 
tion, fits of coughing, and threatened suffocation, accompanied by dis- 
charges of varying character. 

When the tumour is largely sessile, the respiration may simply be 
snoring or whistling, without any suggestion of suffocation ; but if, on 
the other hand, it is pedunculated, displacement of the polypus produced 



336 



LARYNX, TRACHEA AND BRONCHI. 



by the currents of air during inspiration and expiration causes spasm of 
the glottis, fits of coughing and threatened suffocation. 

The diagnosis is not always easy, though examination of the nasal 
cavities, the sinuses, trachea and chest gives negative results. Ausculta- 
tion of the larynx may suggest the existence of the lesion, but an exact 
diagnosis can only be attained by digital examination of the larynx 
through the pharynx. 

The prognosis of these tumours is grave, because death from 

asphyxia may occur during an 
attack of coughing or as a con- 
sequence of the fits of suffoca- 
tion. 

Treatment. As it is usually 

C* ' ^^-^ ""^ extremely difficult, if not impos- 

^ sible, to discover the exact nature 
of the tumour, medical treat- 
ment, except for instance in the 
case of actinomycosis, is of very 
uncertain value. 

Surgical treatment alone sug- 
gests itself. Before attempting 
an operation tracheotomy should 
be performed and a metal canula 
inserted. The animal having 
been cast, and the upper laryn- 
geal region anaesthetised by 
means of cocaine, a vertical in- 
cision is made in the median 
line below the larynx, passing 
through the skin, the vertical 
junction between the neck mus- 
cles and the three first circles 
of the trachea, and access is 
thus obtained to the larynx and subglottal region. The operation 
should only be performed in exceptional cases, such as that of a valu- 
able stud animal. 

Provided that the new growth has a well-developed pedicle it can be 
removed through the mouth by the use of an ecraseur or simply by 
tearing out. 




Fig. 170. — Sessile form of intra-laryngeal 
polypus. 



BRONCHITIS. 



Diseases of the bronchi in bovine animals reveal very different 
characters, according to the nature of the primary cause, for which 



SIMPLE ACUTE BRONCHITIS. 337 

reason cases occur of simple acute bronchitis, verminous bronchitis, 
simple chronic bronchitis, pseudo-membranous bronchitis, tuberculous 
bronchitis, etc. 

SIMPLE ACUTE BRONCHITIS. 

Simple acute bronchitis coexists with, or is often only the logical 
and inevitable complication of, coryza and acute laryngitis. It is com- 
monly associated with inflammation of the mucous membrane of the 
trachea. 

It accompanies cold and wet seasons, and usually appears with the 
autumn frosts, in animals still at grass. In animals under shelter it 
occurs after undue exertion followed by chills, and after sudden rain 
storms. It also attacks working oxen, which are much exposed to the 
weather. 

The symptoms follow^ very rapidly on the determining cause. They 
are ushered in by rigors, trembling attacks, diminution or loss of appe- 
tite, arrest of rumination, acceleration of breathing, and the appearance 
of a rough and spasmodic cough. 

In ordinary cases these symptoms rapidly diminish, even without 
treatment. The appetite again becomes moderate, rumination returns, 
but the cough remains more or less rough and spasmodic, ending in the 
discharge, or more often in the swallowing, of abundant bronchial 
mucus. 

This is the condition at the period of crisis. Percussion of the 
thorax reveals normal resonance. On auscultation of the sides during 
the period of onset, rough rales are heard, which at the period of crisis 
are replaced by mucous rales. The cough diminishes in frequency, and 
after a fortnight everything again becomes normal. 

The diagnosis is very easy, the important point being not to con- 
fuse common bronchitis with tuberculous bronchitis, which very often 
assumes a chronic form. 

Prognosis. The prognosis is not grave, even though the disease may 
assume a chronic condition. 

Treatment does not differ from that of acute bronchitis in the horse. 
It consists in antiseptic and steam fumigations, te]3id drinks, the 
administration of doses of 2 to 3 drachms Kerme's mineral in 
adult animals, and of 1 to IJ drachms of iodide of potassium, given 
in a mash or in honey electuary. During convalescence tar water 
should be administered. 

CHRONIC BRONCHITIS. 

Chronic inflammation of the mucous membrane of the large 
bronchi and trachea may follow^ acute bronchitis, but it is also a frequent 
D.c. z 



338 LARYNX, TRACHEA AND BRONCHI. 

termination of verminous bronchitis. It is fomid in fully developed 
animals, adult or old, and particularly in those inhabiting wet, cold 
valleys. 

It is characterised by frequent paroxysms of coughing, which appear 
on the slightest provocation, such as the action of cold air on leaving the 
stable or of the air of a confined space on animals returning from the 
open ; concussion of the chest by the pleximeter, squeezing of the loins, 
rapid movement, etc. 

This coughing is accompanied by the discharge of mucus, which 
rarely arrives at the nostrils, but is swallowed in passing through the 
pharynx. Such mucus is always thick, greenish yellow in colour, and 
without smell. 

The respiration, although regular whilst the animal is at rest, becomes 
accelerated on moving, and after attacks of coughing. It is sometimes 
rapid and whistling. 

Percussion discloses neither partial nor complete dulness, but every- 
where irregularly distributed mucous rattling and sibilant rales are 
revealed by auscultation. 

There is no fever, the appetite is maintained, and, what is an even 
more important point, animals in good condition preserve their flesh. 
Interlobular pulmonary emphysema and emphysema resulting from 
dilatation are inseparable accompaniments of chronic bronchitis, for 
which reason the flank respiratory movement is frequently very 
^narked. 

The diagnosis is of only moderate difficulty, because although in 
certain conditions the disease may be mistaken for tuberculosis or 
emphysema, it can be distinguished by bacteriological examination of 
the discharge, by an injection of tuberculin, by careful auscultation, 
and by consideration of the general condition. 

Lesions. The walls of the bronchi are thickened, the submucous 
connective tissue is sclerosed, the muscular fibres are modified in 
structure, and have become fibrous, while the epithelial layer is des- 
quamated and suppurating. The peribronchial tissue also undergoes 
sclerosis, and in certain cases the smaller bronchi present marked 
dilatations resembling small caverns (bronchi-ecstasis). 

Treatment can never be more than palliative ; the aim should be to 
prevent the lesions becoming aggravated, and to check the pathological 
secretion from the bronchi, but the lesions already existent can never 
be removed. Tar water should be perseveringly administered. Essence 
of turpentine in doses of 2 to 2J drachms per day in electuary 
(adults), creosote in doses of IJ to IJ drachms, and terpine in 
doses of f to 1 drachm give the best results, and produce a marked 
improvement. 



PSEUDO-MEMBRANOUS BRONCHITIS. 839 



PSEUDO-MEMBRANOUS BRONCHITIS. 



The pseudo-membranons forms of bronchitis, formerly termed 
" croupal or diphtheritic bronchitis,"' are rare. They develop suddenly 
or follow pseudo-membranous laryngitis. Like the latter, they are due 
to a specific infection, possibly aided by accidental causes. 

Their causation is imperfectly understood, and they cannot be com- 
pared, still less homologated, with diphtheritic disorders in man. They 
are characterised by the formation of false membranes, which develop on 
the mucous surface, mould themselves over the internal surface of the 
large bronchi, and ramify throughout the bronchial channels like 
branches of trees. They are of greyish-yellow^ colour, and appear to be 
formed of fibrin, coagulated albumen, and epithelial debris cemented 
together with mucus. 

Symptoms. At the outset these pseudo-membranous forms of 
bronchitis have the same characters as acute bronchitis, which at the 
crisis w^ould be marked by the expulsion of fragments of false membrane 
by coughing. Most frequently it seems that the bronchitis follows its 
regular course, and in such case it is only during convalescence or a 
considerable time afterwards that the membranes begin to be discharged 
during paroxysms of coughing. 

The patients are subject to intense dyspnoea, appear about to suffo- 
cate, and during the efforts then made the false membranes are dis- 
charged in the form of half-organised layers, or, on the other hand, in 
branched masses, resembling twigs. 

The dyspnoea at once ceases. Despite the development of these 
false membranes in the bronchi, no alarming symptoms are produced, 
which is explained by the fact of the false membranes being adherent 
only to the inner surface of the principal conduits, without closing or 
even markedly obstructing them or the smaller passages leading to 
the pulmonary alveoli. "When, however, they are displaced, violent 
reflex spasms are produced as soon as the fragments approach the 
larynx. 

Diagnosis. The diagnosis rests entirely on examination of the 
expectorated material. 

So far as the prognosis is concerned, it is less grave than might be 
supposed from the symptoms. The gravity arises from the fact that this 
disease has a certain tendency to become chronic. 

Treatment scarcely differs from that of ordinary bronchitis. Tar, 
creosote in doses of 2J to 5 drachms given in oil ; terpine in doses of 
^ to f drachms per day can be recommended. Iodide of potassium also 
has certain advantages. 

z 2 



340 LAEYNX, TRACHEA AND BRONCHI. 

VERMINOUS BRONCHITIS IN SHEEP AND CATTLE (hUSK, HOOSE, ETC.). 

Lambs, young sheep, and calves sometimes suffer severely from infes- 
tation with lung worms, w^hich set up great irritation in the bronchial 
passages, leading to chronic bronchitis. The animals show frequent 
attacks of paroxysmal coughing, during which some of the parasites may 
be expelled. The irritation produced causes serious loss of condition, 
and if not alleviated may lead to death. The parasite of the sheep is 
known as Strongylus filaria (sheep lungworm), that of the calf Strongylus 
micriinis. The worms are from 2 to 4 inches long, whitish in colour, 
and of the diameter of a hat-pin. 

Treatment. According to generally accepted views among veteri- 
narians and zoologists, it is a comparatively simple matter to kill 
worms in the bronchial tubes, and a number of cases of the disease 
are reported in literature which are alleged to have been cured. These 
views, however, are open to very serious doubt. 

Neumann (1892b, pp. 590, 591, 593, 594) summarises the subject of 
treatment as follows : — 

Two different procedures in treatment are pursued. In one, sub- 
stances are passed into the digestive canal, which, being diffused in the 
blood, are believed to be capable of attacking the worms in the bronchial 
tubes. With this view, the picrate of potash (0*20 to 0*40 gram per head) 
is given, dissolved in thin gruel or mucilage ; creosote ; oil of turpentine ; 
a mixture of equal parts of oil of turpentine and tincture of camphor — a 
teaspoonful every day to each lamb in a mucilaginous fluid ; a mixture of 
creosote 120 grams, spirits of wine 500 grams, and water 700 grams— 
an ordinary spoonful every day to each animal ; or creosote 60 grams, 
benzine 300 grams, water 2 litres — an ordinary spoonful given every day 
for eight days to each sheep. Hall states he has successfully employed 
prussic acid in ten-drop doses, morning and evening. 

But experience has shown that, while such treatment is troublesome 
to carry out, its efficacy cannot be relied upon. 

Success is more certain with fumigations, as they penetrate directly 
to the worms, stupefy them, and induce fits of coughing that cause expul- 
sion. They are practised in buildings from which all forage is previously 
removed, and which are well closed. Into these the diseased [animals] 
are introduced, and on a red-hot shovel are placed rags, horns, feathers, 
hair, old pieces of leather, empyreumatic oil, tar, juniper berries, 
asafetida, etc. The intensity, duration, and number of these fumiga- 
tions are graduated as the sheep become accustomed to them. At first 
once a day may suffice, and then the intensity should be moderate and 
the duration about ten minutes; afterwards two, and finally three, may 
be given during the day, each lasting for twenty minutes. Kowalewsky 



VERMINOUS BRONCHITIS IN SHEEP AND CATTLE (HUSK, HOOSE, ETC.). 341 

says he has obtamed very good results from shnilar fumigations. Fumi- 
gations with chlorine, sulphur, and sulphuret of mercury or cinnabar 
have been recommended, but they are dangerous. 

(Stephen recommends as follows : Put about forty lambs at a time 
into an air-tight house, and place tar, sulphur, and turpentine in a pot of 
burning coals, suspended by a chain from the ceiling and brought as 
near to the heads of the animals as possible ; the fumes are to be allowed 
to fill the house, and more ingredients are added as required, the lambs 
being kept in the place for twenty-five minutes each time, and the process 
to be repeated on three occasions.) 

Tracheal injections in the verminous bronchitis of calves are of great 
utility ; but for a flock of sheep they would be troublesome and difficult 
to administer. However, Nieman, has successfully employed them on 
384 sheep belonging to several small owners. He used a solution of 2 
parts iodine and 10 parts iodide of potassium in 100 parts of distilled 
water. This fluid was mixed, in equal parts, with oil of turpentine, and 
made into an emulsion with olive oil ; each sheep received 5 to 8 
grams of the mixture, and the number of the injections varied according 
to the gravity of the disease — from two to three at two days' interval. 
The worms were killed and expelled during the paroxysms of coughing, 
and the bronchitis was modified. 

The medical treatment should be assisted by very nourishing food, 
and by bitter, stimulating, and ferruginous tonics, which arouse the 
digestive functions and allow those animals which are least exhausted to 
reach the period of elimination of the parasites. 

At the commencement of any kind of treatment it is well to have an 
examination of the flock, with the object of sending the worst oases to 
the butcher. 

The same medicaments have been employed in treating this malady 
in calves as in that of sheep, and no better results have been obtained. 
Numann and Janne have, however, been successful with asafetida (30 
grams), Chabert's empyreumatic oil (60 grams), and a mucilaginous 
decoction (500 grams) — a spoonful of this mixture being given in a half 
litre of milk, and the treatment continued for about a month. 

The results are less uncertain if the worms lodged in the bronchial 
tubes are directly acted upon, either by means of injections of the same 
kind as those employed for sheep, or fluid medicaments introduced 
directly into the bronchi. 

Bead says he has cured calves w^orn down almost to skeletons by 
verminous bronchitis by the following procedure : The head of the calf 
is slightly elevated, and about 2 drachms of ether, chloroform, oil of 
turpentine, or rectified oil of amber — single or combined — are poured 
into each nostril and allowed to vaporize there ; it will then, by the 



342 LARYNX, TRACHEA AND BRONCHI. 

respiration, be carried into the air passages, and thus destroy the filarise. 
In some cases it must be repeated two or three times, but once has 
frequently the desired effect. 

The method of treatment by intra-tracheal injection, introduced by 
Levi, of Pisa, has yielded very satisfactory results. Levi has been com- 
pletely successful with a sheep. Eloire has employed it in sixteen calves 
affected with the disease, and all were cured. He used the following 
mixture : Black poppy oil, 100 parts ; oil of turpentine, 100 parts ; car- 
bolic acid, 2 parts ; purified cade oil, 2 parts. Each calf received 10 
grams of this mixture daily for three days. 

The injection, which should be given slowly, is followed by a fit of 
coughing, and the expired air has the odour of turpentine. This treat- 
ment has also been successful at Milan. Similar favourable results have 
followed Hutton's treatment of eight calves, some of which were in the 
last stage of verminous bronchitis. He employed a mixture of oil of 
turpentine, tincture of opium, pure carbolic acid, and water — the oil 
of turpentine forming one-half of the mixture. The dose was ^ an 
ounce, and in the serious cases this was given every day for three days, 
and in other cases every second or third day. Kriwonogow has likewise 
cured twenty-two calves by giving each of them two tracheal injections of 
8 grams of the following mixture : Essence of cloves and oil of turpen- 
tine, 360 parts of each ; carbolic acid and olive oil, 30 parts of each. 

(Williams speaks highly of the administration of prussic acid. 
Penhale gives — by intra-tracheal injection, and slowly — oil of turpentine 
2 drams, carbolic acid 20 minims, and chloroform J a dram.) 



CHAPTER IV. 

LUNGS AND PLEURAE. 

PULMONARY CONGESTION. 

Besides passive congestions of the lung, which it is unnecessary to 
describe here, and which result from cardiac or pericardiac affections or 
the compression of important vessels, there sometimes occm-, particularly 
among young animals, cases of active congestion of the lung. Such cases 
are produced by over-exertion on the part of animals which have escaped 
from control or have been chased by dogs. 

They are most common in animals usually kept in stables, but which 
have accidentally escaped, or in very fat animals. 

Dyspnoea and cough are the chief symptoms. The animals stop as 
though exhausted, extend their neck and head, dilate their nostrils and 
thrust their limbs out on either side of the body, while at the same time 
they appear in a condition of terrible distress. 

The respiration is rapid and short, the patient can scarcely breathe, 
and asphyxia seems imminent. On auscultation it seems that the 
respiratory murmur has disappeared over almost the entire extent of 
the lung. 

Death may occur very quickly. 

The diagnosis is extremely easy, provided that the history is known. 

The prognosis is grave. 

One of the most successful methods of treatment consists in free 
bleeding. In a great majority of cases this causes the symptoms to 
abate as though by enchantment. Cutaneous stimulation by mustard 
and similar irritants, as well as ablutions of cold water, are useful. The 
animal should be placed in a very airy spot. 

SIMPLE PNEUMONIA. 

History. Veterinary surgeons have long been divided in opinion on 
the question whether simple pneumonia occurs in animals of the bovine 
species. Whilst some affirm it, others think that all lesions of the lung 
in the ox, apart from pneumonia due to foreign bodies, should be 
regarded as of the nature of peripneumonia. 



344 LUNGS AND PLEUKJi:. 

Some ten years ago two veterinary surgeons of the department of the 
Aisne, Coulon and Ollivier, practising in a district where peripneumonia 
rages, made some extremely interesting observations on pneumonia in 
the ox. Their object was to distinguish between contagious peri- 
pneumonia and simple j^neumonia during life, simple pneumonia having 
formerly been regarded as a non-contagious peripneumonia. Despite 
the rather unfavourable conditions in which ordinary practitioners are 
frequently placed, these gentlemen performed a work of great value. 
The facts which point to the occurrence of simple pneumonia are as 
follows : — 

The disease is not contagious. One may allow affected animals to 
mix with normal subjects without the disease being communicated. 
Pulmonary exudate from cases of simple pneumonia can be injected 
into the dewlap and hind quarters of young and adult animals, with- 
out pathological results. 

The lesions and course of simple pneumonia entirely differ from 
those of peripneumonia. 

Causation. Simple pneumonia is not common, and only occurs 
quite exceptionally in fat stock, or in milch cows kept in stables at a 
regular temperature, as in the north of France and near Paris. 

It occurs most commonly -in working animals, which are exposed to 
variations in temperature and to chills. By causing vascular disturb- 
ance, chill favours microbic infection and visceral inflammation. Trasbot 
has described the case of an ox which, after having worked hard, and 
whilst freely sweating, was left exposed to the wind under a shed for 
about three hours. This animal contracted unilateral pneumonia the 
following day. 

Coulon and Ollivier have seen the disease in animals living in damp, 
low-lying valleys, or valleys exposed to the north wind, which are ex- 
posed in consequence to great variations in temperature. 

The symptoms follow almost the same course as in the horse, and 
one may distinguish three periods : — 

I. Period of onset. The symptoms which mark the onset of the 
disease are moderate fever, which progressively increases, and accelera- 
tion of respiration and of circulation. The number of the respiratory 
movements rises to twenty or twenty-five per minute, those of the 
pulse to fifty, sixty, or eighty. The conjunctiva becomes injected, and 
then of a yellow tint. At this period the appetite never disappears 
completely, rumination is regular, and there is neither tympanites nor 
colic. 

These general symptoms, which are not of special significance, are 
supplemented by more precise local symptoms — an abortive, difficult and 
painful, cough which is easily induced, and a whitish discharge. The 



SIMPLE PNEUMONIA. 345 

rusty expectoration which is characteristic of simple pneumonia hi the 
horse and m man has never been observed. 

Percussion discloses partial dulness, usually on one side, in the lower 
region of the chest : the respiratory murmur in this region is ascertained 
by auscultation to haA^e diminished, whilst in the upper part and also on 
the opposite side the respiratory murmur is increased. 

II. Period of exacerbation. This period is characterised by accen- 
tuation of all the symptoms: the temperature rises, and may attain 
104° Fahr. ; the submaxillary artery is tense; the dulness becomes 
more marked, whilst crepitant and mucous rales are heard. In the 
portions still unattacked the function of the lung is exaggerated in 
order to make up for the defect of the diseased parts, and the respira- 
tion becomes juvenile. 

The appetite, which previously had been maintained, diminishes con- 
siderably, without, however, entirely disappearing, and intense thirst sets 
in, as a consequence of the fever. 

III. Period of crisis. The general symptoms remain stationary for 
four or five days ; the respiration, which is always affected, sometimes 
becomes as rapid as thirty to forty per minute; the tubal souffle which 
invariably occurs in pneumonia of the horse is not always clearly 
audible. 

Terminations. (1.) Eesolution. — This is indicated by the attenuation 
of all the symptoms and the disappearance of fever, which gradually 
sinks from 105° to 101° Fahr. The respiratory moA^ements become fuller 
and foAver in number, the pulse slower, and the artery softer and more 
compressible. The cough changes its character, is stronger, more 
sonorous and prolonged, and is accompanied by the free discharge of 
muco-pus. The dulness descends, and the tubal souffle, if preA^ously 
existing, is replaced by the returning crepitant rale. In general the 
disease runs its course in eight to ten days in young and in fourteen 
to fifteen days in aged subjects. 

(2.) Death by asphyxia is almost the only fatal termination of 
pneumonia in the ox. It occurs in one-third to one-fourth of the 
subjects attacked. Its approach is announced by a deep mahogany- 
red coloration of the conjunctiva. The pulse becomes very rapid, 100 
to 110 per minute, thready, small, and almost imperceptible, Avhilst the 
beating of the heart is strong and tumultuous. Pvespiration is rapid and 
very laboured (50 to 70 per minute). The animal's attitude is typical; 
it stands with its limbs thrust out, its head extended, its nostrils 
dilated, and its mouth half open, discharging foamy and viscous saliA^a. 
Throughout the greater portion of the lung gurgling sounds and 
crepitant mucous rales can then be detected. 

(3.) Cases ending in gangrene and suppuration are excessively 



346 LUNGS AND PLEUR.E. 

rare, and others resulting in chronic pneumonia have not been 
authoritatively described. 

Pneumonia is distinguished from broncho-pneumonia by the exist- 
ence of dulness at the period of crisis, whilst in the case of broncho- 
pneumonia this period is only marked by partial dulness, which is even 
then sometimes slight. Moreover, broncho-pneumonia usually develops 
much more slowly. 

The disease, then, is distinguished from peripneumonia by the 
following points: — 

(a) By the character of the temperature curve, which is regular in 
pneumonia, only attaining its highest point at the period of crisis, whilst 
in peripneumonia it ascends suddenly, and presents sadden oscillations. 

(h) The a]^petite remains, although diminished. 

(c) Sensitiveness in the region of the ribs is but feebly marked, or is 
entirely absent, simple pneumonia not being accompanied by pleurisy. 

(d) The dewlap never shows oedema, a symptom which usually 
accompanies the period of crisis in peripneumonia, when the jugular 
veins and the anterior vena cava are compressed. 

{(') These signs alone are almost sufficient on which to base the 
diagnosis, but they are often supplemented by two others, of some- 
what less importance (for in exceptional cases they may also be 
observed in simple pneumonia), viz. — the absence in most instances 
of a membranous sound, and of a well-marked souffle. 

Prognosis. Two-thirds of the cases recover. This proportion might 
be increased if the veterinary surgeon were called in at the beginning. 

Lesions. Post-mortem examination reveals neither pleural exudate 
nor pleural lesions. The lung is large and of increased weight, hepatised 
along its lower borders, and congested in its upper part. 

The sero-haemorrhagic infiltration of the interlobular spaces varies, 
according to the region examined : the upper regions are engorged and 
black, owing to capillary haemorrhages and blood clots, which completely 
surround the pulmonary lobule, the latter being violet or brownish-red 
in colour. In the hepatised portions the lobules are of a washed-out 
reddish tint, and the interspaces of a whitish colour. 

The bronchi are filled with frothy, whitish mucus; the small bronchi 
sometimes contain fibrous concretions and the mucous membrane is 
injected, and may be destroyed in places. The bronchial lymphatic 
glands are enlarged, congested, and contain small haemorrhages. 

It is important in making a post-mortem examination to be able to 
distinguish pneumonia from peripneumonia. This is comparatively 
easy if one bears in mind that in the latter pleurisy always exists, 
that the interlobular connective tissue spaces are always greatly dis- 
tended with a citrine-coloured serosity, that on section the peripneu- 



PNEUMONIA DUE TO FOREIGN BODIES— MECHANICAL PNEUMONIA. 347 

monic lung resembles a mosaic ; and that, finally, the course of 
hepatisation is centripetal, the inflammation commencing at the peri- 
phery of the lobule, and progressively extending towards the centre. In 
pneumonia, on the contrary, pleurisy is always absent; the interlobular 
connective spaces are only distended slightly, if at all, and always con- 
tain a brownish-red serosity : the course of hepatisation is centrifugal ; 
it commences in the pulmonary alveoli, and extends towards the peri- 
phery and the interlobular divisions. The following table gives a 
resjLiKe of the other differences between the two diseases : — - 



Peripneinnonia. 

(Edema of the dewlap. 

Pleural exudate. 

Centripetal lobular hepatisation. 

Extreme infiltration of the interlobular 
connective tissue spaces (primary yellow 
infiltration) . 



Pneumonia. 

No oedema of the dewlap. 

No pleural exudate. 

Ascending centrifugal lobar hepatisa- 

tion. 
Moderate infiltration of the interlobular 

connective tissue spaces (secondary 

reddish-brown infiltration). 



Treatment. Good hygiene, regular ventilation, moderate w^armth, 
and the administration of tepid drinks facilitate recovery. 

Certain German authors recommend cold compresses to the thorax, 
douches, and cold enemata in pneumonia. We do not think that such 
treatment has proved very successful, although it has been well tried. 

The classic treatment commences with moderate bleeding, the free 
application of mustard to the sides, the application of moxas, frictions 
with antimonial or blister ointment, and the administration of draughts 
containing 2 to 2J drachms of tartar emetic per day, or considerable 
doses of alcohol; and this treatment seems to have given the best re-' 
suits. Antithermic agents, like acetanilide, phenacetin and quinine sul- 
phate, are too costly to be greatly used in bovine medicine. Salicylate of 
soda is preferable. 

In order to assist circulation, support the tone of the heart and avoid 
engorgement of the lung and asphyxia ; digitalis should be given in doses 
of f to 1 drachm per day, or digitalin in subcutaneous injections of 5 to 6 
milligrammes, continued for five or six days. Finally, iodide of potassium 
may be given in doses of 1 to 1^ drachms, to reduce inflammation and as 
an expectorant. 



PNEUMONIA DUE TO FOREIGN BODIES-MECHANICAL 
PNEUMONIA. 

It may happen that in examining a patient pneumonia is diagnosed 
under circumstances which seem to forbid its being regarded as simjDle 
or primary. This may be explained by the fact that ruminants are very 



348 LUNGS AND PLEURA. 

apt to suffer from pneumonia produced by foreign bodies. The lung may 
be penetrated either by some sharp object making its way forwards from 
the rumen or recticuhnn or by hquid or soHd material passing into the 
trachea. These are two common methods by which this form of pneu- 
monia is produced. 

PNEUMONIA DUE TO THE MIGRATION OF FOREIGN BODIES FROM 
THE RETICULUM. 

Causation. The conditions under which food is swallowed by rumi- 
nants after preliminary mastication permit indigestible objects, such as 
stones, fragments of wood, nails, needles, bits of iron wire, etc., to enter 
the rumen, whence they reach the reticulum in consequence of peristaltic 
movements. Sharp, perforating objects, like needles or fragments of iron 
wire, penetrate the walls of the gastric compartments, and, impelled by 
the movements of these organs, pass through the intervening tissues, 
usually in the direction of the heart. Under conditions which cannot 
precisely be defined, these foreign bodies make their way towards the 
pleural cavity (usually the right, in consequence of the situation of the 
reticulum), traverse the diaphragm, and directly penetrate the base of 
the lung. 

As the migrating object is usually infected, its passage through the 
diaphragm always produces a localised patch of diaphragmatic pleurisy. 
Although possible, it is only rarely that the pleural sac becomes generally 
infected, or that rapidly fatal septic pleurisy is set up. Usually the 
localised pleurisy causes the base of the lung to become adherent to 
the anterior surface of the diaphragm. The foreign body continuing 
its movements, passes into the lung, and there sets up pneumonia. 

Symptoms. When the practitioner is first consulted he often finds 
only indications of the crisis period of a localised pneumonia at the base 
of the affected lung. The symptoms include fever, accelerated breathing, 
moaning, loss of appetite, cough without discharge, dulness over the base 
of the lung on percussion, disappearance of the respiratory murmur in 
the dull area, souffle opposite the inferior bronchi, and normal or juvenile 
respiration towards the front, i.e., in the anterior lobe, and sometimes 
in the cardiac lobe. 

The temptation under such circumstances is to deliver a diagnosis 
of simple pneumonia with prognosis of probable recovery. It should be 
remembered, however, that in all cases of basilar laneumonia without 
affection of the anterior lobes there is a considerable chance of the con- 
dition being due to the presence of a foreign body. On more careful 
examination it is found that the intercostal spaces opposite the affected 
region are very sensitive, and that the circle of the hypochondrium is 



MIGRATION OF FOREIGN BODIES FROM THE RETICULUM. 349 

correspondingly sensitive. The owner, moreover, almost always informs 
the practitioner that for several weeks his animal has coughed, shown 
tympanites, diminished appetite, etc. 

Compression of the roots of the corresponding diaphragmatic nerve 
at the base of the neck always produces coughing. 

These symptoms rarely accompany the development of simple pneu- 
monia. Furthermore, the course of this accidental pneumonia is en- 
tirely different. Instead of developing regularly according to the above- 
described cycle, pneumonia due to foreign bodies develops slowly, and 
only becomes well defined after several weeks, whilst its tendency is to 
grow more and more aggravated. The zone of dulness extends both in 
a forward and upward direction. The souffle extends forwards. Auscul- 
tation and palpation sometimes reveal the formation of an abscess or 
local gangrene ; while there is slight oedema of the wall of the chest, as 
well as a gurgling sound at the moment when the lung is displaced, 
high fever, intensely coloured urine, and very marked leucocytosis, etc. 
Death is inevitable, and when gangrene exists it sometimes occurs 
suddenly. 

Diagnosis. The diagnosis is based on the information furnished with 
regard to the course of the disease, the localisation of the hepatised zone, 
and the- progressive character of the affection. 

The diagnosis, nevertheless, is always a little doubtful, but may be 
so far assured as to attain the position of a quasi-certainty. 
Prognosis. The prognosis is unequivocal. 

Treatment. No practical treatment, either to extract the foreign 
body or to combat the special pneumonia which it has produced, can 
be attempted. All the interlobular connective layers and the lobules 
themselves are invaded by various micro-organisms carried by the foreign 
body. Numerous fragments of tissue serve as centres of suppuration and 
gangrene, and the only chance would lie in attempting resection of the 
lung. Such intervention has no practical interest in veterinary surgery. 
It is true that when the existence of an abscess is suspected, an aseptic 
exploratory puncture may be made, and, in the event of the diagnosis 
being so far confirmed, the abscess might be opened through an inter- 
costal space. Under such circumstances, however deep the point of 
penetration of the foreign body, the development of the resulting abscess 
causes local pleurisy and adherence between the pleura and lung, so 
that there is no immediate danger of producing purulent pleurisy and 
pneumo-thorax. If small the foreign body might possibly be discharged 
through the passage thus afforded. 

In practice the best plan is to recommend slaughter as soon as 
the diagnosis becomes certain, provided that the meat can still be 
utilised. 



SoO 



LUNGS AND PLEURA 



PNEUMO'MYCOSIS DUE TO ASPERGILLI. 



The term pneumo-mycosis, or pulmonary aspergillosis, is used to denote 
a condition due to the growth in the respiratory apparatus of a fungus 
of the order aspergillus (family, Perisporue ; sub-order, Perisporiacece ; 
order, Ascomycetes). 

In ruminants, as in all other animals, pulmonary aspergillosis 
occurs accidentally, and may often pass unperceived, in spite of the 
indications given by Lucet and Bournay regarding its development and 
symptoms. 

It seems most frequently to be caused by Aspergillus niger and Asper- 
gillus famigatus, particularly by the latter, which, according to Eenon's 
w^ork, also appears to be the most pathogenic. It only develops in animals 
whose respiratory apparatus is injured and is the seat of such lesions as 
those of chronic bronchitis, bronchi-ectasis, and of parasitic lesions 
or those containing cavernous spaces resulting from abscess formation, 
etc., etc. 

The fungi, or more properly the spores, which have accidentally 
penetrated into the respiratory channels germinate and develop in the 
pathological dilatations, causing disseminated areas of pneumonia and 
some mechanical disturbance, but not producing intoxication by liberating 
toxins. 

Causation. Infection occurs through the air passages, in conse- 
quence of the inspiratory current carrying spores of the fungi into 
the ramifications of the bronchi, where they develop if the soil is 
favourable. Development is favoured if the animals exposed to con- 
tamination are in bad condition, or if, as sometimes happens, the w^alls 
of the stables are not kept clean, and are covered with various forms 
of fungi. 

Prolonged feeding on musty fodder may also favour respiratory in- 
fection ; but it seems highly improbable that under ordinary conditions 
infection can occur through the digestive tract. Infection of the lung 
must also be regarded as exceptional, if one bears in mind the frequency 
with which oxen are fed on musty or mildew^ed fodder and the small 
number of accidents recorded. 

Symptoms. " The symptoms are obscure, and pulmonary aspergillosis 
is often only discovered on post-mortem examination. A cough is the 
chief symptom. It is dry at first. Afterwards it becomes spasmodic 
and frequent. 

Kespiration is difficult, dyspnoeic, effected only with effort, and some- 
times even discordant. Expiration is sighing. 

Percussion reveals zones of partial or complete dulness when the 
lesions are near the surface of the lung, which, however, is rare. 



GANGRENOXJS BEONCHO-PNEUMONIA. DUE TO FOREIGN BODIES. 85l 

Bourn ay has noted the occurrence of a musical sound resembhng that 
obtained by tapping a small crystal or glass bell. 

Auscultation is said to reveal rough or sibilant rales, but as the 
lesions occur only in animals whose respiratory apparatus has already 
been impaired, it is difficult to offer an opinion on the subject. 

These signs are invariably accompanied by a certain amount of general 
ill-health, wasting, and irregularity of appetite and of rumination. 

On post-mortem examination the lung of the affected animal aj)pears 
strewn with nodules, varying in size between a hazel-nut and a walnut. 
On section, Bournay claims to haA^e found a wall or fibrous shell 
covering a greenish cryptogamic growth, in the centre of w^hich was a 
yellowish, sharply defined kernel formed of masses of fangi {Mycelium, 
sterigmata and spores). In cases of rapid development, the pulmonary 
tissue around the parasitic lesion is completely hepatised. 

Diagnosis. Diagnosis is impossible without recourse to microscopic 
examination of the discharge. This examination, which, however, is 
somewhat difficult, may, after staining, result in the detection of debris 
of the mycelial filaments and of spores, with or without bacilli of tuber- 
culosis. The diagnosis as regards fungi can only be assured by preparing 
cultures. 

Prognosis. The prognosis is grave, because the disease is always 
superadded to lesions, which of themselves would justify a sombre view. 

Treatment. In consequence of the small number of observations pub- 
lished and the difficulty in diagnosis, no rational treatment has hitherto 
been laid down. From a purely theoretical standpoint, fumigations with 
tar and essence of turpentine and the inhalation of carbolic sj^ray have 
been recommended. Life in the open air would, without doubt, be 
equally or more efficacious. Preventive treatment consists in with- 
holding musty fodder and keeping the stables clean. 

GANGRENOUS BRONCHO-PNEUMONIA DUE TO FOREIGN 

BODIES, 

Foreign bodies which find their way into the trachea instead of 
the oesophagus provoke in most cases broncho-pneumonia, which very 
rapidly terminates in gangrene and death. 

Causation. Forced feeding of sick animals which have lost their 
appetite is one of the principal causes of this grave condition. In 
order to administer food such as mashes, gruel, hay tea, etc., the ox- 
herds have a bad habit of lifting the entire head and drawing forward 
the tongue whilst they pour the concoctions into the animal's mouth. 
The liquid cannot then be divided into portions, deglutition in the 
pharynx is badly effected, and the substances administered find their 



352 LUNGS AND PLEUR.E. 

way partly into the larynx and partly into the oesophagus. In the case 
of astringent, bitter, or highly stimulating drugs, a similar accident may 
be caused by s^Dasm of the pharynx or oesophagus, where the tongue has 
not been left free and excessive quantities have been given. 

Again, during the course of diseases complicated with paralysis of the 
pharynx (cow pox, parturient apoplexy), obstruction of the pharynx and 
oesophagus (tympanitic indigestion), intense pharyngeal dysphagia (foot- 
and-mouth disease), etc., the risk of broncho-pneumonia due to foreign 
bodies is much greater still. It may even occur spontaneously in animals 
in the enjoyment of complete freedom (foot-and-mouth disease). 

Lastly, cases of broncho-pneumonia have been described as a conse- 
quence of inhaling foreign bodies, when the animals are fed, for example, 
with meal made from undecorticated cotton-seed. Under such circum- 
stances the lesions produced are similar to those of pneumoconiosis in man 
(the chronic forms of pneumonia of miners, charcoal-burners, quarrymen, 
stonemasons, etc.). 

Symptoms. The symptoms of gangrenous broncho-pneumonia 
become apparent immediately after the foreign body has entered the 
trachea. They commence with a violent, spasmodic cough, produced 
by reflex action, which in its turn is due to the laryngeal mucous mem- 
brane having been touched. But this cough is now too late to be of use, 
for the food, drug or liquid has passed into the depths of the trachea, 
and cannot be ejected. The cough soon ceases, and the animals may 
even return to their food. These appearances, however, are deceptive, for 
twelve, twenty-four or forty-eight hours later the cough reappears, whilst 
appetite diminishes. The attacks of coughing are succeeded by the dis- 
charge of a greyish or reddish-grey offensively smelling material; respira- 
tion becomes more rapid, the heart's action violent, and the temperature 
rises to 103° or even 105° Fahr. (B9-5 to 40-5° C). 

The patients soon refuse all solid food, and if the chest is then 
examined by percussion one finds partial dulness, rarely simple dulness, 
over the cardiac lobes opposite the point where the girth passes. The 
partial dulness may rise to a varying height on both sides ; sometimes 
it is confined to one side. 

On auscultation the respiratory murmur in the upper two thirds of 
the lung appears exaggerated on both sides, and is found to have 
greatly diminished, or disappeared altogether in the inferior zone. 

Auscultation through the scapula almost always shows that the 
anterior lobes are affected ; but, at all events, in the examinations we 
have made, checked by post-mortem examination, the cardiac lobes have 
always proved to be most affected, a fact attributable to the direction of 
the principal bronchi. The lower portion of the posterior lobes may 
also be affected, but this is rarer. All the lower zone is irregularly 



GANGRENOUS BRONCHO-PNEUMONIA DUE TO FOREIGN BODIES. 353 

hepatised, and on auscultation one hears large moist rales, whilst 
respiration sometimes appears of a blowing character, and divided by 
a pause, but there is no tubal souffle. If the patient survive for a 
certain time, the sounds heard on auscultation undergo change; gurgling 
noises and sometimes true cavernous souffles are heard, as a result of 
suppuration in the bronchi and gangrene of one or more areas in the 
lung. Diffuse gangrene is rare, and the inferior zone is usually the only 
portion affected. 

During this phase the expired air has an absolutely characteristic 
gangrenous odour. 

Death occurs by asphyxia and intoxication, but some animals hold 
out for a fortnight and more. 

Lesions. Post-mortem examination reveals a suppurative but 
secondary inflammation of the mucous membrane of the nasal 
cavities, pharynx, larynx, and trachea. 

In the bronchi, sometimes very deeply placed, remains of foreign 
bodies are found in cases where some solid material has been inhaled. 
The mucous membrane of the bronchi is violet in colour, in places 
appears to be sloughing, and is covered by gangrenous patches immersed 
in a reddish-grey putrid fluid of offensive odour. In places the pul- 
monary tissue has undergone gangrene; and incision of the diseased 
centres discovers irregular cavities, filled with a pultaceous, greyish 
material, which often makes its way into the bronchi. These are the 
irregular cavities which give rise to the gurgling sounds. The walls of 
these cavities are formed of disintegrating pulmonary tissue, which 
again is surrounded by a zone of grey hepatisation. The gangrenous 
areas may unite, forming vast caverns. If near the surface they 
cause adhesive or septic pleurisy. 

Diagnosis. The diagnosis is not very difficult, provided that an exact 
account can be obtained of the circumstances which preceded the appear- 
ance of the disease. The signs furnished by the discharge, the expired 
air, percussion and auscultation are sufficiently significant to remove any 
doubt. 

Prognosis. The prognosis is extremely grave, and in the great 
majority of cases fatal. 

Treatment. There is very little chance of recovery, no matter what 
treatment may be employed. The most favourable termination consists 
in the gangrene remaining limited to the bronchi and to a small frag- 
ment of the lung, so that the damaged tissues, being gradually delimited 
and sloughed off, may finally be discharged by coughing. 

This is an exceptional termination, but attempts may be made to 
assist its evolution by giving alcohol in doses of 8 to 10 ounces per day, 
and salicylate of soda in doses of 4 to 5 drachms. When the condition 

D.C. A A 



3o4 LUNGS AND PLEURA. 

can be early diagnosed before intense and continued fever has set in, 
and when the animal's condition is good, it is often preferable to 
slaughter the patient. 

INFECTIOUS BRONCHOPNEUMONIA. 

The ox's lung is liable to so many and such extremely varied 
diseases that it seems desirable to add to the above descriptions 
some remarks on infectious broncho-pneumonia of external or in- 
ternal origin. 

Anatomically these forms of broncho-pneumonia are characterised 
by the occurrence of " islands " of pulmonary hepatisation, more rarely 
by extensive (massive) hepatisation ; in all cases the hepatisation is 
irregular, and in no way resembles that of simple pneumonia. 

Causation. The internal causes are numerous and varied. They 
are due to primary infection of an organ whence arises a general infec- 
tion, sometimes even true septicaemia. Some form of broncho-pneu- 
monia, such as simple broncho-pneumonia, purulent broncho-pneu- 
monia, gangrenous broncho-pneumonia, etc., then follows as a compli- 
cation. These broncho-pneumonias are therefore only manifestations 
of purulent infection or septicaemia. They frequently follow post- 
partum infections, vaginitis, metritis, and suppurative mammitis. 

Symptoms. The general symptoms first attract attention, and are 
extremely acute. They comprise high fever, loss of appetite, cessation 
of rumination and of milk secretion, breathlessness, blowing, etc. — all 
signs of grave and rapidly progressive infection. 

Sometimes at this period nothing more than the primary lesion, such 
as metritis or mammitis, can be detected. It may even happen that the 
uterus seems little affected, and, despite the accelerated respiration, 
neither partial nor complete dulness of the lung is discovered. 

Hepatisation only occurs some days afterwards, and with it irregular 
partial dulness localised in the lower zones, disappearance of the respira- 
tory murmur in the corresponding regions, exaggeration in the infected 
regions, an expiratory sound which is barely perceptible or may be of a 
blowing character, or, again, after several days may be transformed into 
a tubal souffle. 

The cough then becomes frequent, generally difficult, paroxysmal, 
feeble, and easily provoked. The appetite suffers, the patients seem 
to prefer fluid nourishment and lose flesh very rapidly. 

If the broncho-pneumonia is about to terminate in suppuration 
or gangrene, the respiration becomes sighing, the breath foetid, and 
the cough is accompanied by a greyish muco-purulent or gangrenous 
discharge. 



INFECTIOUS BRONCHO-PNEUMONIA. 355 

When the abscesses are deep-seated, the alarming symptoms retain 
their primary degree of intensity for weeks, until the animals are 
completely exhausted. Abscesses, originating in deep-seated parts, 
may even extend towards the surface of the lung, and produce either 
adhesive pleurisy that can be detected by palpation, or exudative 
pleurisy, easily recognised on percussion. 

When the infective microbes are not pyogenic the general con- 
dition appears less grave, the animals exhibit only moderate fever, 
apj)etite is diminished but not lost, wasting is slower, and may con- 
tinue for months, but the affected portions of lung become converted 
into fibrous masses or a material resembling spleen pulp. 

The duration of infectious broncho - pneumonia, therefore, varies 
with the nature of the infecting organism. In cases which terminate 
in gangrene, the animals may survive for three or four weeks ; in 
those where suppuration occurs, for several months. In short, recovery 
is the rule in simple broncho-pneumonia ; but from an economic stand- 
point there is little reason for keeping the animals alive. 

Diagnosis. The diagnosis is not generally very difficult ; for if at first 
the case may be mistaken for one of simple pneumonia, the persistence 
or prolonged aggravation of the symptoms and the irregularity in posi- 
tion of the lesions revealed by percussion and auscultation enable the 
condition to be distinguished at an early period from simple pneumonia. 

Confusion with acute or chronic pleuro-pneumonia may easily be 
avoided by noting the absence of pleural effusion, and of the soft 
pleuritic souffle of peripneumonia, etc. 

Where auscultation is chiefly relied upon it is more difficult to 
differentiate between this disease and acute tuberculosis, and between- 
it and broncho-pneumonia produced by foreign bodies, although the 
latter disease develops differently. 

Prognosis. The prognosis is always extremely grave and, in cases 
where there is gangrene or abscess formation, fatal. From the economic 
standpoint the chronic form is also very grave. 

Treatment. As broncho-pneumonia is frequently of a secondary 
character, treatment should at first be particularly directly against the 
primary condition, whether in the mammary gland, uterus or else- 
where. Early treatment of suppurative mammitis, metritis, etc., is 
therefore necessary. 

Broncho-pneumonia is treated by free vesication of the walls of 
the chest, the administration of tonics and antiseptics, alcohol in small 
doses, acetate of ammonia in doses of 1 to 2 drachms, salicylate of 
soda in doses of 5 to 8 drachms per day, salicylic acid in doses of 1 
drachm, and creosote in doses of 1^ to 5 drachms, given in electuary, etc. 

Diuretics, farinaceous gruels, etc., may be used freely, and are of value. 

A A 2 



356 LUNGS AND PLEURA. 

If the symptoms persist or become aggravated, and suggest the 
development of an abscess or gangrene, it is better to slaughter the 
animal. 

BRONCHO-PNEUMONIA OF SUCKING CALVES. 

Young animals still with the mother, particularly calves during the 
first few weeks of life, are liable to broncho-pneumonia of a specialised 
character, as regards not only its causes, but its development and duration. 

Causation. The causes may be grouped under two principal heads : — 

(a) In slow or difficult cases of parturition, the foetus may be injured 
whilst being delivered, as a consequence of direct compression of the 
great blood-vessels, etc. (particularly of compression of the umbilical 
cord, compression of the thorax in the cardiac region, or partial pre- 
mature separation of the envelopes), and may thus by reflex action 
make automatic inspiratory movements. 

Kespiration being impossible, inasmuch as the thorax has not yet 
passed the posterior passages, such inspiratory efforts made during 
the passage through the pelvis may cause amniotic liquid to pass into 
the bronchi. This accident is particularly liable to occur during 
deliveries with breech presentation. If, as happens frequently, the 
amniotic liquid has become infected either prior to or as a conse- 
quence of obstetrical manipulation, the result is fatal ; for the pas- 
sage of infected amniotic fluid into the bronchi develops a broncho- 
pneumonia of a degree of gravity depending on the character of 
infection. 

(b) By an entirely different mechanism broncho-pneumonia may 
occur in sucking calves during the first few weeks of life, even in the 
case of animals born in a vigorous condition, and kept in warm and 
well-arranged stables. This form follows diarrhoea, and constitutes a 
final complication which is always of very marked gravity, and in 
most cases fatal. 

Such secondary broncho-pneumonia only occurs when the diarrhoea 
has resisted treatment, and it is important to note that the pectoral 
lesions appear at a time when the intestinal mischief seems to have 
diminished, the diarrhoea having lessened or disappeared. This variety 
of broncho -pneumonia of young animals is by far the most frequent. 
It has been termed broncho-pneumonia of intestinal origin, and exactly 
resembles, so far as its development and gravity are concerned, the 
broncho-pneumonia in young infants described by Sevestre and Lesage. 

The term broncho-pneumonia, moreover, is not strictly correct, or 
at least is not exclusive ; for the rapid forms often exhibit lesions 
other than those of broncho-pneumonia. Post-mortem examination 
reveals pleurisy and pericarditis. 



BRONCHO-PNEUMONIA OF SUCKING CALVES. 357 

Pathogeny. At the outset of these attacks of broncho- pulmonary 
disease, a careful bacteriological examination of the organisms to be 
found in the discharge of bronchial mucus leads to the discovery of 
bacilli which do not stain with Gram, and which resemble varieties 
of the colon bacillus ; in other cases of streptococci. At a later stage, 
when the animal has become weak, micro-organisms are present in 
much greater variety. Nocard found in lung abscesses the bacillus 
of epizootic lymphangitis. It seems that the development of various 
lesions in the thoracic cavity may be due to auto-infection, i.e., to 
the penetration from the intestine of germs which, after passing 
through the circulation, establish themselves at some point in the 
lung. The pleura is attacked at a later period as a consequence of 
continuity and contiguity of tissue. 

In a similar way pericarditis and even valvular endocarditis may be 
produced. 

Symptoms. The symptoms are similar to those of all forms of 
broncho -pneumonia. Where diarrhoea has been neglected, the condi- 
tions may apparently improve without evident cause, whilst the respi- 
ration becomes more frequent. The patient soon suffers from cough, 
and in a few hours the existence of broncho-pneumonia is clearly 
apparent. Acceleration of breathing is the dominant symptom. The 
respirations may rise to fifty to sixty per minute, at which they con- 
tinue, while fever sets in. On percussion the thorax may appear of 
normal resonance throughout ; but when pleural lesions and exudates 
exist, resonance gives place to partial or complete dulness. Should 
pericarditis or small cardio-pericardial adhesions exist, they may escape 
observation, but if the exudate is abundant or the adhesions multiple or 
of large size the usual symptoms of pericarditis develop progressively. 

On auscultation the respiratory murmur is always found to be greatly 
exaggerated in the healthy parts, usually the upper portions of the lung. 
On the contrary, it is attenuated or suppressed in the affected regions. 
The other signs vary greatly, according to the extent, intensity, and more 
or less advanced condition of the lesions. Crepitant and bronchial rales, 
blowing respiration and tubal souffles, etc., are among the symptoms. 

The duration of the disease varies ; some patients may be carried off 
in five or six days, while others survive for one or two months, or even 
longer. A few recover, but they remain thin, puny, and atrophied, and 
are not worth keeping alive. 

Lesions. The lesions extend to the bronchi, the pulmonary tissue, 
and sometimes the pleura and pericardium. They consist in lesions of 
diffuse broncho-pneumonia, pleurisy with false membranes and parieto- 
pulmonary adherences, and pericarditis with partial cardio-pericardial 
adhesions. 



358 LUNGS AND PLEURA. 

In rare cases abscesses caused by pyogenic streptococci may be 
found. 

The anterior lobes, cardiac lobes, and lower part of the posterior lobes 
are those singled out for attack. 

Diagnosis. The diagnosis is not difficult, provided that the circum- 
stances preceding the appearance of the pulmonary lesions are known. 

Prognosis. The prognosis is very grave. 

Treatment. Treatment very often proves useless, because the patients 
have little resisting power and are exhausted, and also because they are 
suffering from a slowly progressive septicaemia. It may, however, be 
worth while in the early stages to apply blisters to the chest and ad- 
minister general stimulants : alcohol in doses of 8 to 12 drachms per day, 
divided into two parts and mixed with milk ; acetate of ammonia in doses 
of J to 1 ounce ; and tinctura digitalis 5 to 6 drops. 

The primary disease of the intestine is masked by the pulmonary 
symptoms, but should not be overlooked. Eice water, sub-nitrate or 
salicylate of bismuth may be added to the milk or albuminous solu- 
tions constituting the diet. When an epizootic of broncho-pneumonia 
complicates the diarrhoea it is necessary to take all the preventive 
measures which have been suggested in connection with white scour 
and umbilical diseases in calves. These comprise disinfection of the 
premises and local disinfection of the animals affected. 

SCLERO'CASEOUS BRONCHO-PNEUMONIA OF SHEEP. 

The sheep suffers from a special form of broncho-pneumonia, which 
is seldom seen except in isolated cases, but which, under exceptional cir- 
cumstances, may nevertheless attack a certain number of animals in a 
particular flock. It was first noticed and described by Lienaux in 1896, 
and has more recently been studied by Sivori (1899). Moussu has only 
seen it in flocks in the north of France. 

Causation. The causes of this disease are still imperfectly under- 
stood. 

Sivori's researches show that the disease may be referred to a micro- 
organism, but we do not yet know exactly by what path infection occurs. 

The agent of sclero-caseous broncho-pneumonia in the sheep appears 
similar to that described by Preisz and Guinard in 1891, and identical 
with the microbe of ulcerative lymphangitis of the horse (Nocard, 1897). 
It is probable that infection occurs through the respiratory apparatus. 

Symptoms. The clinical development of the disease is difficult to 
describe, because its course is slow and unaccompanied by well-marked 
external signs. 

The animals lose flesh, pant for breath when moved, drop to the 
rear of the flock cough frequently, feed badl and end by becoming 



PULMONARY EMPHYSEMA. 359 

cachectic. Many suffer from the disease and yet remain in fair bodily 
condition. 

On post-mortem examination the kmgs are found not to collapse, 
having lost their elasticity, and are of a yellowish-^Yhite colour, which is 
only seen in this disease. On section the pulmonary tissue appears 
dense, hard, and of a fibrous and lardaceous character. At various 
points nodules ^Yith fibrous envelopes and caseous, yellowish or greenish 
contents are found. 

When the caseous nodules are near the surface the pleura may be 
chronically inflamed and thickened. The liver and kidney frequently 
contain caseous lesions. 

Diagnosis. The diagnosis becomes easy after the first post-mortem 
examination, for the lesions discovered cannot be mistaken for those 
of parasitic broncho-pneumonia, degenerated pulmonary echinococcosis 
or tuberculosis. In the living animal, on the contrary, the diagnosis 
is extremely difficult. 

Prognosis. The prognosis is grave. No special method of treat- 
ment is known. 

PULMONARY EMPHYSEMA. 

Pulmonary emphysema, i.e., exaggerated dilatation of the pulmonary 
tissue by air, is not uncommon in the bovine species, and occurs under 
the two classical forms — (1) alveolar or intra-lobular emphysema limited 
to dilatation of the alveoli ; and (2) interlobular emphysema, produced 
by the entrance and diffusion of air in the interlobular spaces in con- 
sequence of rupture of the lobules. 

These two forms are very frequently associated : — 

(1.) Emphysema by dilatation usually begins in the right pretracheal 
lobe ; also in the cardiac and even in the posterior lobes. 

(2.) Interlobular emphysema begins in the same regions, but it 
spreads readily in a backward direction, remaining interstitial ; or, on 
the other hand, becoming sub-pleural at the periphery of the lung. 

In both cases the j)ulmonary tissue is pale, the blood-vessels are 
partially obliterated by compression ; circulation and aeration of the 
blood are impeded — hence the appearance of the disturbance noted. 

Causation. Emphysema is seen in adult working oxen ; also, and to 
an even greater 'degree, in aged cows. It is produced by excessive strains 
in draught, or more often by the paroxysms of coughing so common 
during simple or parasitic bronchitis, broncho-pneumonia, pneumonia, 
chronic broncho-pneumonia, etc. Successive gestations also produce it. 

All these pathological conditions also interfere with the nutrition of 
the bronchial mucous membrane, particularly of its deep-seated muscular 
layer, which is then incapable of regulating the distribution of air in the 



360 LUNGS AND PLEURA. 

bronchial channels. The distribution being no longer regulated by reflex 
action, air accumulates at certain points as a result of the expiratory 
efforts made during coughing, and dilatation of the vesicles or lobules 
occurs. 

Diseases of the digestive apparatus, acute or chronic tympanites in 
particular, may play a certain part by compressing the diaphragm, 
causing expiratory efforts and fits of coughing. 

Furthermore, swelling of the lymphatic glands at the entrance to 
the chest, by compressing the pneumo-gastrics, provokes reflex cough 
and finally emphysema. 

Symptoms. Pulmonary emphysema is marked by accelerated re- 
spiration due to diminution in the respiratory capacity, which is often 
very seriously affected ; to insufficient absorption of oxygen in con- 
sequence of diminution in the space available for exchange of gases in 
the lung, and to insufficiency of expiration. This acceleration in breath- 
ing, though little marked during repose, becomes very pronounced after 
exercise, or during hot weather ; and under these circumstances is 
accompanied by a paroxysmal, feeble but shrill cough, without discharge. 
This cough without discharge is frequently followed by swallowing. 

Percussion reveals an important point, viz., increase in the normal 
resonance of the thorax. 

On auscultation the vesicular murmur is found to be diminished, the 
respiration assumes a rough and rasping character, inspiration is diffi- 
cult, expiration painful, and often divided into two periods, as indicated 
by a slight double movement of the flank. Expiration is clearly audible. 
Its duration is generally less than that of inspiration, although in some 
cases it is equal or even longer. It is accompanied by sibilant and 
snoring relies, sometimes even mucous rales, of an intermittent character. 
In rare cases there may be difficulty of respiration, as in broken-winded 
horses. 

Diagnosis. The diagnosis may suggest a doubt as to whether 
emphysema or tuberculosis is present, but in the latter there is fever, 
the general condition is poor; on percussion the thorax reveals areas 
of partial dulness ; and expiration is rough and prolonged, sometimes of 
a blowing character, a peculiarity which is exceptional in emphysema. 

Prognosis. The prognosis is not very grave, except where emphy- 
sema is only an accompanying symptom of another disease, such as 
chronic bronchitis, tuberculosis, etc. 

Treatment. Little can be done to check the development of the 
above described pulmonary lesions ; but the cough may be relieved, and 
the pulmonary circulation improved by assisting the heart. 

The most prompt and efficacious assistance is given by digitalis in 
doses of J to 1 drachm per day for adults, iodide of potassium in doses of 



DISEASES OF THE PLEURA. 3G1 

1 to IJ drachms, and bromide of potassimn in doses of 1 drachm to 
guard against reflex excitability of the ]3nenmo-gastric. This treatment, 
however, should not be followed for more than five or six days, and 
should then be replaced by the administration of arsenious acid in doses 
of 15 grains per day, ground horse-chestnuts in doses of 3 ounces per 
day, etc., etc. 

DISEASES OF THE PLEURA. 

Primary inflammation of the pleura is very rare in animals of the 
bovine species, but secondary diseases of this membrane, on the other 
hand, are frequent. 

ACUTE PLEURISY. 

Cruzel, Fabry, and a number of practitioners have described the 
occurrence in woridng animals of acute pleurisy a fric/ore or sero- 
fibrinous pleurisy in consequence of severe, sudden variations in tem- 
perature or prolonged chills. At the present day it seems fairly well 
established that pneumonia, and not pleurisy, is commonest under such 
conditions, and Moussu disclaims ever having seen primary pleurisy. 
On the other hand, pleuritic effusions are very common in contagious 
pleuro-pneumonia, secondary pleurisy due to pericarditis produced by 
foreign bodies, septic broncho-pneumonia or broncho-pneumonia due to 
foreign bodies, and the pleurisy which accompanies septicaemia con- 
sequent on parturition, etc. These forms of disease, however, are not 
simple sero-fibrinous pleurisy, but septic or suppurative pleurisy, still 
little understood in veterinary surgery. 

Tuberculosis of the pleura, although very frequent, is rarely accom- 
panied by marked exudation. Like secondary disseminated pleural 
carcinoma, it usually assumes the vegetative and adhesive form, with 
adhesions of greater or less extent between the lung and wall of the chest. 

Symptoms. In all these morbid conditions the symptoms vary 
greatly, and it would be difficult to give an accurate general descrip- 
tion of them. 

In acute pleurisy a frig ore shivering attacks, moderate fever, dulness, 
loss of appetite, interference with rumination, dryness of the skin, rapid 
wasting and intercostal pain, first indicated by dull colic, constitute the 
usual symptoms. 

The respiration is short and irregular, interrupted when the exuda- 
tion is abundant. Pressure over the intercostal spaces produces pain, as 
does strong percussion. Percussion reveals an area of dulness bounded 
above by a horizontal line. 

Auscultation shows the respiratory murmur to have disappeared 
throughout the zone of dulness, and reveals the presence of a soft 



362 LUNGS AND PLEURA. 

pleuritic souffle (a soft tubal souffle quite different from that of con- 
tagious pleuro-pneumonia) when pleural exudation is abundant. In 
septic or suppurative pleurisy fever is higher, loss of appetite more 
marked, wasting more rapid, and depression extreme, with, however, 
identical local symptoms. 

Diagnosis. The diagnosis of pleural exudation presents little diffi- 
culty, because of the peculiar characters of the dulness and the pathogno- 
monic indications obtained by auscultation. The exudation is usually 
unilateral, the mediastinum being very resistant and not perforated 
in the ox. 

By passing the needle of a Pravaz's syringe with antiseptic pre- 
cautions through the intercostal space a little fluid may be drawn off 
and the diagnosis formed, the form and nature of the pleurisy being 
simultaneously established. The liquid extracted can be examined bac- 
teriologically, and can be grown on nutritive media, or inoculated into 
experimental animals. 

The prognosis is grave, because in the ox pleurisy is very often of 
a secondary character. The outlook varies, however, with the form of 
the pleurisy and the nature and virulence of the infecting organism. 

Treatment. Treatment consists firstly in applying an energetic 
vesicant like antimonial ointment or liquid cantharides blister ; in- 
ternally diuretics such as soda bicarbonate, nitrate of potash, resin, 
and decoctions of pellitory, dogs' grass, etc., may be given. If thought 
desirable the chest may be tapped and the pleural cavity washed out 
with an antiseptic solution. 

CHRONIC PLEURISY. 

Chronic pleurisy is frequent in aged animals, but usually assumes the 
form of local adhesive pleurisy. The adhesions between the lung and 
pleura are more or less extensive ; they result from verminous broncho- 
pneumonia, echinococcosis, external injuries, etc. Clinically this form 
is of no importance, and is almost impossible to diagnose. During 
the development of pleural tuberculosis, on the contrary, adhesive dry 
pleurisy is frequent, and sometimes becomes so well marked that almost 
the whole of the opposing pleural surfaces may become united. 

PNEUMO'THORAX. 

The name pneumo-thorax is given to the condition produced by the 
entrance of air or gas into one of the pleural cavities. 

The accident is usually produced by rupture of the parenchyma of 
the lung and of the pleura, a rupture which produces a communication 
between the alveoli or a bronchus and the corresponding pleural cavity. 



PNEUMO-THORAX. 



363 



As soon as the rupture occurs air passes from the lung into the pleural 
cavity, and the lung collapses in consequence of the resilience of its 
elastic constituents. 

Under other, much rarer, circumstances pneumo- thorax occurs in con- 
sequence of gas generated in the digestive tract passing into the pleural 
spaces. The condition then makes rapid progress, and death occurs in a 
few days. 

Symptoms. The symptoms are well defined. As soon as the acci- 
dent occurs the animal exhibits extremely marked and sudden dyspnoea, 
accompanied by heaving at the flank or 
general agitation of all the muscles of 
the body. One of the lungs, in fact, has 
suddenly been called on to perform the 
functions of both, and at first it natu- 
rally has great difficulty in meeting this 
demand. 

The heaving at the flank and the 
general agitation of the body muscles is 
due to the fact that the regularity and 
rhythm of contraction of the diaphragm 
are disturbed, and the mechanical condi- 
tions have become different on the two 
sides. From the first, respiration is 
moaning and expiration becomes rapid, 
stertorous and deep, while the face is 
anxious-looking, and the nostrils are di- 
lated as though the animal was on the 
point of suffocation. On examining the 
animal from in front or behind, the thorax 
is easily seen to be wanting in symmetry, 
the side on which the pneumo-thorax 

has occurred being immobile as compared with the sound side. The 
latter, moreover, is dilated in order to compensate for the loss of function 
of the collapsed lung. 

Percussion reveals greatly increased resonance on the side of the 
pneumo-thorax. On the other hand, the opposite side yields a normal 
sound. 

Auscultation reveals an increase of the. respiratory murmur on the 
side which is still acting and, on the contrary, complete and total sup- 
pression of the respiratory murmur on the affected side. On applying 
the ear to the chest wall, a large soft, amphoric souffle of well-marked 
metallic character is heard. This is particularly clear on respiration, 
giving the impression of the existence of a large cavity beneath the ear. 




Fig. 171. — Schema illustrating open 
pneumo-thorax. Right lung col- 
lapsed ; pericardium and heart 
displaced towards the right. 



364 LUNGS AND PLEURA. 

The sighing sound heard on auscultation of the chest wall is louder than 
that heard externally or over the region of the nostrils or larynx ; and it 
seems to be reinforced, as though by the resonance of a large cavity with 
thin metallic walls. Once or twice per minute, moreover, a sound may 
be heard like that of dropping water. It is of a very special character, 
resembling that produced by drops falling to the bottom of a hollow 
metallic vase, and setting up prolonged vibration. 

As secondary symptoms the heart's action is accelerated, the number 
of beats rising to 80 or even 120 or 130 beats per minute ; appetite is 
lost ; slight tympanites develops as a result of rumination and eructa- 
tion being suspended ; the peristaltic movements of the rumen are inter- 
rupted, and constipation develops. 

Diagnosis. The diagnosis of pneumo-thorax is easy, and the con- 
dition can scarcely be mistaken for any other except diaphragmatic 
hernia ; but the indications derived from percussion and auscultation 
are so different in the two cases that they need not be further 
emphasised. 

The task becomes more difficult, however, when an attempt is made 
to identify the exact form of pneumo-thorax, for three principal varieties 
are recognised. 

In ojDen pneumo-thorax, the first and most frequent form, air passes 
from the lung into the pleura at each inspiration, and flows back from 
the pleural cavity tow^ards the bronchus at each expiration. The intra- 
pleural pressure is then approximately equal to the intra-bronchial 
pressure, and undergoes similar oscillations. (It should be noted that 
the aperture in the lung is seldom sufficiently large to establish an 
absolute equality of pressure between the bronchus and the pleural 
cavity. Eespiration, therefore, though very seriously impeded, generally 
continues in a modified form.) 

In a second variety, termed " valvular pneumo-thorax," air passes 
freely from the lung into the pleural cavity, but is unable to return 
from that cavity towards the lung, because a flap of tissue acts as a 
valve and closes the orifice at the commencement of expiration. As 
soon as intra-pleural pressure rises above that of the inspiratory effort, 
the valve remains permanently closed. 

In the third variety, called " closed pneumo-thorax," the orifice of 
communication is obstructed by some mechanism, and the pleural sac 
only contains a film of air. 

In practice, valvular pneumo-thorax is recognised by the movement 
of the thoracic wall (which in open and closed pneumo-thorax remains 
depressed), as well as by extreme intensity of the dyspnoea and attacks of 
threatened suffocation. Closed pneumo-thorax, which is only a termina- 
tion and a stage in the cure of open pneumo-thorax and of valvular 



PNEUMO-THORAX. 365 

pneumo-thorax, is suggested by progressive improvement in the symp- 
toms. Scientifically it is very easy to make this diagnosis by putting a 
manometric apparatus in communication with the pleural cavity by means 
of a simple hollow needle provided with a thick- walled rubber tube. 

In open pneumo-thorax the liquid column in the manometer under- 
goes rhythmic oscillations corresponding to the respiratory movements ; 
in valvular pneumo-thorax the intra-pleural pressure increases progres- 
sively until it becomes higher than the external pressure ; and finally, 
in closed pneumo-thorax, the column of the manometer assumes a cer- 
tain level at which it rests. 

Prognosis. The prognosis is very variable, according to the primary 
cause of the accident. Animals might recover, but economically there 
is little advantage in preserving them when the diagnosis is assured, 
except in cases of animals of great value, and when the primary disease 
admits of it. 

Causation. Pneumo-thorax may be produced by various causes. 
The most frequent cause in large animals is pulmonary echinococcosis, 
during the course of which a peripulmonary vesicle, after having injured 
several lobules, one of the air passages or even a bronchiole, may break 
through the pleura, thereby setting up direct communication between 
the bronchi and the pleural cavity. 

To pulmonary tuberculosis, with peripheral softened tubercles, 
perforating simultaneously into an alveolus or a small bronchus and 
into the pleura, must be assigned the second place. 

Vesicular and interstitial sub-pleural pulmonary emphysema is also 
a frequent cause of pneumo-thorax, the pleura being ruptured over the 
emphysematous points. 

Finally, and exceptionally, an abscess of the lung may open into the 
pleura and form sinuses, which may establish a communication between 
the digestive reservoirs and pleural-sacs ; but such accidents produce 
pyo-pneumo-thorax and septic pleurisy of a rapidly fatal character. 

The diagnosis of pneumo-thorax, and even of its varieties, does not, 
however, enable one to form a prognosis ; the important point is to 
ascertain the original cause. 

Treatment. It may be said of pneumo-thorax that no treatment 
exists, and that the position is one of expectancy. In fact, we possess 
no means of directly dealing with such diseases as echinococcosis, tuber- 
culosis, or emphysema. For this reason it is best as a rule to advise 
slaughter. Nevertheless, when the condition is due simply to pulmonary 
echinococcosis of a discrete character, there is some chance that after' 
several months the animal may recover spontaneously. The communi- 
cating orifice becomes closed by reparative processes (cicatricial contrac- 
tion, the formation of a false membrane, limited adhesion between the 



366 



LUNGS AND PLEURA. 



two walls of pleura, etc.) ; the layer of air imprisoned within the pleural 
cavity is progressively absorbed, provided that it has not been acci- 
dentally infected ; the collapsed and partially splenised lung progres- 
sively regains its function under the inspiratory efforts, and after some 
months complete recovery may occur. This termination cannot always 
be confidently predicted, because complications may arise at any moment ; 
under no circumstances can complete recovery be anticipated when the 
primary disease is tuberculous. 

In cases of valvular pneumo-thorax with extreme oppression, attacks 
of suffocation threatening death as a consequence of excessive intra- 
pleural pressure, displacement of 
the mediastinum towards the oppo- 
site side, compression of the heart, 
and functional disturbance of the 
sound lung, it may be worth con- 
sidering whether the attacks of 
suffocation and threatened asphyxia 
can be modified or removed by pre- 
venting the excess of intra-pleural 
pressure. By simply passing a stout 
hollow needle through one of the 
intercostal spaces, the intra-pleural 
pressure may be reduced to that of 
the external atmosphere, and the 
effects of compression removed. 
This, however, is a last resort, and 
has no permanent effect. 




Fig. 172. — Hydro-pneumo-thorax. I, Point 
of adhesion of the pleura ; P, healthy 
lung ; Ps, splenised lung ; E, liquid 
or purulent exudate ; Ca, air cavity 
constituting pneumo-thorax ; C, heart. 



HYDRO-PNEUMO-THORAX AND 
PYO'PNEUMO'THORAX. 

When pneumo-thorax is set up, 
it rarely remains simple. In the 
great majority of cases the pleura 
becomes infected, either directly, by the lesion which has determined 
the pneumo-thorax (tubercle, superficial abscess, actinomycotic lesion, 
etc.), or secondarily, by the penetration of germs from the air or from 
the bronchus (echinococcosis, emphysema). Simple pneumo-thorax then 
becomes converted into hydro-pneumo-thorax or pyo-pneumo-thorax, 
according to circumstances — that is to say, whether the exudation into 
the pleural cavity is of a simple character or is of the nature of pus. 
Symptoms. Hydro-pneumo-thorax is characterised by the signs 
common to true pneumo-thorax, which constitutes the primary lesion, 
viz., sudden difficulty in breathing, exaggerated unilateral resonance, 



HYDRO-PNEUMO-THORAX AND PYO-PNEXTMO-THORAX. 867 

amphoric souffle accompanied by a sound like that of drops of water 
falhng into a metalUc vessel, and by the signs of secondary exudative 
pleurisy, viz., moderate fever, dulness over the lower zones of the chest, 
limited above by a horizontal line, slight splashing sound, and a soft 
distant pleuritic souffle. 

All the secondary symptoms — loss of appetite, suppressed rumination, 
sighing, accelerated pulse, etc. — are found in a more or less accentuated 
form. 

In pyo-pneumo-thorax fever is more marked, while the signs noted 
on auscultation and percussion are identical, and are accompanied by 
digestive disturbance and marked oedema of the wall of the chest, 
which can be seen or detected by palpation. 

Diagnosis. The diagnosis is relatively easy when the lesion is 
secondary; but the difficulty (as in simple pneumo-thorax) is to identify 
the exact character of the primary affection. 

On the other hand, pyo-pneumo-thorax and hydro-pneumo-thorax 
are not always complete ; adhesions of very varying character may exist 
between the lung and the chest wall ; hence it is impossible to group 
together all the possible symptoms. 

Diagnosis is facilitated by aseptically puncturing the chest wdth a 
Pravaz's syringe. 

Prognosis. The prognosis is extremely grave even in cases of hydro- 
pneumo-thorax. Treatment is useless, for even allowing that the primary 
disease might be cured, this process of cure, after reabsorption of the 
transudate, w^ould be extremely tedious, and the animals w^ould long 
remain in poor condition. 

Treatment. In hydro-pneumo-thorax no treatment is advisable. 
Nothing is gained by thoracentesis, at least at an early stage, or before the 
lesion causing the pneumo-thorax has closed. 

In pyo-pneumo-thorax, on the contrary, the theoretical course is to 
evacuate the pus and completely wash out the pleural sac with lukewarm 
non-irritant solutions of antiseptics. 



CHAPTER V. 

DISEASES OF STRUCTURES ENCLOSED WITHIN THE 

MEDIASTINUM. 

The mediastinum is a space enclosed in the median plane of the 
thorax by the approach of the two opposite layers of pleura. Needless 
to say, at those points where the layers are in apposition, the space is 
theoretical only. It extends from the suprasternal region to the dorsal 
subvertebral region, and encloses all the vessels which pass from or to 
the base of the heart, the trachea, the oesophagus, the pneumo-gastric, 
diaphragmatic and cardiac nerves, etc., as well as the pericardial sac and 
the heart. The organs most frequently affected are the lymphatic glands 
lodged in the thickness of the mediastinum, the glands placed at the 
entrance to the chest, the bronchial glands, and the glands situated in the 
posterior mediastinum. 

Inflammation of the mediastinum may coincide with inflammation of 
the mediastinal layers of the pleura ; but this can only be detected on 
post-mortem examination. The lesions which can be recognised during 
life are simple inflammation of glands, resulting from pulmonary or 
pleural diseases, tuberculous inflammation of glands, and the presence of 
cancerous tumours of the mediastinum and hypertrophy of glands due 
to lymphadenitis. 

Simple inflammation of the lymphatic glands is secondary and 
consecutive to broncho-pneumonia, verminous bronchitis, infectious 
bronchitis, etc. 

It produces reflex irritation by compressing the pneumo-gastric and 
laryngeal nerves, and is indicated by loud, spasmodic coughing. 

Treatment consists in administering iodide and bromide of potassium, 
terpine, in doses of 1 drachm per day for adults, essence of turpentine 
and tar water. 

Tuberculous inflammation of glands, inseparable from pulmonary 
tuberculosis, has very special characteristics peculiar to tuberculosis. 

Inflammation due to lymphadenitis is also very easy to diagnose 
as a rule, in consequence of the symmetrical enlargement of lymphatic 
glands elsewhere. 



TUMOURS OF THE MEDIASTINUM. 369 

TUMOURS OF THE MEDIASTINUM, 

Sarcomata, carcinomata, lymphomata, and lympho-sarcomata all 
occur in the mediastinum. They attack young healthy animals, and 
sometimes develop with such rapidity that in a few weeks they become 
generalised and invade the heart, lungs, and principal viscera. Their 
cause is at yet unknown. 

Symptoms. At first sight the symptoms are much like those of 
pericarditis caused by foreign bodies. They consist in deformity of 
the presternal region, swelling of the jugulars, submaxillary oedema, 
irregular pretracheal tumefaction, etc. 

The tumour, whatever its nature, commences in the mediastinum, 
develops towards the entrance to the chest, where it projects, and before 
long produces in the pretracheal region clearly marked oedematous 
swelling. 

Between the two first ribs the tumour compresses the carotids, the 
jugulars, the nerve trunks, and also the trachea and oesophagus, pro- 
ducing difficulty in the return circulation, especially in the jugulars, 
swelling in the submaxillary space, loss of appetite and dyspnoea. 

Palpation affords indication of a tumour of soft consistence, bosse- 
lated, more or less adherent to the skin, usually painless on pressure, 
and of irregular development. Compression of the oesophagus inter- 
feres with the deglutition of rough forage, impedes rumination, prevents 
eructation, and thus produces trifling but permanent tympanites. 

The heart is affected reflexly or directly as a result of generalisation 
of the tumour, and the pulse may rise to 70 or even 120 per minute. 

During the first stages neither auscultation nor percussion points to 
any pulmonary lesion. At a later stage the lung itself may be affected. 
The other important functions are normal. 

Animals suffering from sarcoma, carcinoma, or lympho-sarcoma of 
the mediastinum waste very rapidly, lose appetite, become feverish, and 
soon develo^D cachexia. 

Diagnosis. The diagnosis of tumour of the mediastinum is easy, 
because of the w^ell-marked character of the apparent symptoms. 

Prognosis. The prognosis must be regarded as extremely grave, 
and in most cases fatal, for there is no active method of intervention, 
extirpation being impossible. 

There is no treatment. The animal should at once be slaughtered. 



D.C. B B 



SECTION IV. 

THE ORGANS OF CIRCULATION. 

SEMIOLOGY OF THE ORGANS OF CIRCULATION. 

The semiology of the circulatory apparatus comprises the clinical 
examination of the heart, arteries and veins, and the examination of the 
pulse and blood. 

Heart. In animals of the bovine species, the heart is situated in the 
thoracic cavity opposite the third, fourth, fifth and sixth ribs, nearly in 
the median plane of the thorax, and inclined from front to back at an 
angle of 70 degrees. 

The pericardial sac touches the extremity of the sternum where it is 
in immediate contact with the lower insertion of the diaphragm. This 
peculiar arrangement favours the development of pericarditis due to 
foreign bodies. 

On the left side the pericardial sac may come in direct contact with 
the internal surface of the thoracic cavity opposite the lower extremity of 
the third, fourth, and sometimes fifth ribs. At all other points the 
pulmonary lobes, as expanded during inspiration, separate it from the 
thoracic wall. 

Although the pericardium and heart are situated in the median plane, 
percussion and auscultation should be performed on the left side, since 
the anterior and cardiac lobes of the left lung are less developed than 
those of the right ; but the heart can be auscultated on the right side, as 
is advisable at times. 

In the healthy ox there exists an area of the left thoracic wall which 
may be called the cardiac zone, on a level with which are heard the 
normal heart sounds. In diseased conditions this zone or area may 
vary in size, and the sounds may be modified. 

The heart can be examined by inspection, palpation, percussion, 
and auscultation. 

Under ordinary conditions inspection reveals nothing in well-nourished 
animals ; but in very thin subjects and in those suffering from recent 
cardiac lesions or pseudo-pericarditis, a rhythmic movement of the chest 
wall is sometimes detected. 



SEMIOLOGY OF THE ORGANS OF CIRCULATION. 



371 



Palpation is performed by placing the open hand on the cardiac zone. 
In this way the cardiac shock can be felt, its degree of intensity judged, 
and, in an imperfect manner, its rhythm. 

Percussion by means of the fingers or a pleximeter discloses the 
extent of the physiological area of partial dulness, due to the presence of 
the heart, as well as its variations in pathological conditions, particularly 
in pericarditis with marked exudation. 

In such cases there may even be complete dulness when the distended 
pericardium thrusts upwards the corresponding pulmonary lobe, and comes 
in contact with the internal 
surface of the thoracic wall, or, 
in cases of pericardial pneu- 
matosis, exaggerated resonance, 
and a tympanitic sound. 

Auscultation is carried out 
either directly or by the stetho- 
scope or the phonendoscope. 
The normal or pathological 
sounds of the heart are thus 
ascertained, as well as the in- 
tensity of the cardiac beats and 
sounds, the frequency of the 
rhythm, etc. 

When injuries have oc- 
curred which cause murmurs, 
it is best to use the stethoscope 
and to apply it at the points 
where murmurs are heard at 
their maximum intensity, i.e., 
exactly at the spot where the car- 
diac shock is noted, and towards 
the base, in the region where 
the great arterial trunks begin. 

In the latter case it is often useful to draw the left fore leg forward. 

Arteries. The arteries are rarely the seat of lesions that can be 
detected by examination, and therefore such examination is usually 
limited to noting the state of the pulse. 

Arteritis and thrombosis of arteries are rare, and although- lesions 
of atheroma have been discovered in certain chronic diseases, such as 
tuberculosis, chronic diarrhoea, etc., they are difficult to detect, even 
on examination per rectum of the bifurcation of the aorta. 

Pulse. The examination of the pulse, on the contrary, is of great 
importance. In animals of the bovine species the pulse may be taken at 

BB 2 




Fig. 173. — Schema of a section through the 
chest opposite the heart. Vg, Left lung ; 
Td, right lung; cp, right and left pleural 
cavities ; P, pericardium ; I, V-, cardiac lobes 
of the lung interposed between the peri- 
cardium and thoracic wall. 



372 THE ORGANS OF CIRCULATION. 

a number of different points, such as the submaxillary artery, on the 
side of the lower jaw : in the case of very thin animals at the radial 
within and in front of the elbow joint ; at the internal saphenous 
artery, at the height of the mamma or scrotum ; or at the coccygeal 
artery, at the base of the tail. 

This examination reveals the frequency (50 to 60 per minute), the 
quality, whether strong, feeble, imperceptible, etc., the regularity, 
etc., etc. 

Veins. The veins are more easily examined than the arteries, on 
account of their superficial position in most cases. 

Inspection and palpation are the only means of examination. 

Inspection shows the degree of fulness or collapse, and also the 
existence or absence of what has been termed venous pulse. 

Venous pulse occurs only at the lower extremity of the jugulars. 
It is very frequent in animals of the bovine species, and in thin animals 
is not necessarily a pathological symptom. It is due to reflux of blood 
in the anterior vena cava under the influence of the expiratory effort ; 
sometimes to emphysema, tuberculosis, etc. ; in other cases to the 
return of blood towards the vena cava and jugulars at the moment of 
auricular systole, as a result of lesions of the tricuspid or auriculo- 
ventricular orifices. 

By palpation of the veins their permeability can be estimated, also 
the degree of distension or obstruction, and the condition of their 
contents. 

Capillary system. Among methods of arriving at the state of the 
circulatory system must be included an examination of the vascular con- 
dition of the accessible mucous membranes, such as those of the eye, 
mouth, nostril, vulva, etc. This examination is easy to carry out, 
and is of value in diagnosing congestive states, pneumonia, and local 
inflammation. 

Blood. Examination of the blood is sometimes necessary for the 
exact diagnosis of certain diseases, and therefore should be carried out 
whenever occasion requires. The physical state, coloration, and rapidity 
of coagulation afford valuable data in certain diseased conditions, and 
indicate the approximate richness in haemoglobin, the normal or ab- 
normal composition of the plasma, and the richness of the blood in 
white corpuscles. 

Microscopic examination is still more valuable, whether carried out 
by the moist method, in which a drop of blood is compressed under a 
cover glass, or the dry method with or without staining. In the latter 
case the specimen is fixed with a mixture of equal parts of alcohol and 
ether or by immersing it in a 1 per cent, solution of osmic acid. 

By this means it is possible to detect the condition of the red and 



SEMIOLOGY OF THE ORGANS OF CIRCULATION. 373 

white blood corpuscles and haematoblasts ; the existence or non-existence 
of lencocytosis and its degree, as well as the existence, for instance, of 
leucocythsemia. 

The blood corpuscles may also be counted. 

Histological examination, supplemented by suitable staining, reveals 
the presence of normal or abnormal blood corpuscles, parasites such as 
piroplasma, or microbes such as bacteria. 

Such examination necessarily presupposes a knowledge of what 
should be looked for in the normal state. 

In normal blood the red blood corpuscles predominate. They are all 
similar in form and, with few exceptions, of the same size. They stain 
strongly with acid solutions such as eosine. In pathological conditions, 
large or giant corpuscles may be found (macrocytes), as well as those of 
medium size (normal) and small size (microcytes). Some are vigorous 
and stain deeply; others, on the contrary, are degenerating or dead, and 
have no greater affinity for one constituent than for another of the 
double or triple stains commonly employed. 

In pathological conditions the hsematoblasts occur in very varying 
Clumbers. 

The white blood corpuscles found in health may be classified as 
follows : — 

Large and small lymphocytes, each of which has a round volu- 
minous nucleus and a narrow border, and contains a non-granular 
protoplasm ; their proportion varies between 22 per cent, and 25 per 
cent. : 

Polynuclear leucocytes or polymorphous leucocytes with a single 
nucleus, which originate in bone marrow, stain best with neutral colours, 
and are present in the proportion of 70 per cent, to 72 per cent. : 

Mononuclear leucocytes with an ovoid eccentric nucleus stain best 
with basic colours, and form about 1 per cent. : 

Polynuclear leucocytes stain best with eosine or acid colours, and 
form about 1 per cent, to 2 per cent. 

When these white blood corpuscles are in larger number the con- 
dition is known as leucocytosis, and when one or other variety is in 
very great excess the condition is known as leucaemia. 



CHAPTER I. 
CARDIAC ANOMALIES* 

ECTOPIA OF THE HEART. 

Ectopia of the heart, i.e., congenital malformation in which the heart 
is displaced from its normal position and thrust sometimes completely 
beyond the thoracic cavity, is not very rare. The heart may be well 
developed, but it is not enclosed by the thoracic walls when the thoracic 
cavity closes during the first stages of embryonic life. The sternum, 
which is cartilaginous and becomes ossified only at a later period, 
remains fissured along the median line, and the fissure, usually of 
oval form and with rounded margins, surrounds the auricles and the 
vessels at the base of the heart. The ventricles form a hernia pro- 
jecting beyond the thorax, which then only contains the two pleural 
sacs and a complete mediastinal partition. The pericardium remains 
undeveloped. 

Despite this malformation, the embryo develops. The foetus may 
in due season be brought forth living, but as a rule death occurs in 
a few hours. 

The diagnosis is easy, but this malformation cannot be treated. 
All that can be done is to protect the ectopiated organ against ex- 
ternal violence in cases where the young creature is born alive. 



CHAPTER II. 
PERICARDITIS. 

Pericarditis consists in inflammation of the pericardial sac. It is 
attributable to different causes, varying in importance and in causation. 

Specific pericarditis may be produced by the tubercle bacillus, or it 
may develop during an attack of contagious peripneumonia. Tuber- 
culous or peripneumonic forms of pericarditis as a rule form only com- 
plications of chronic pulmonary tuberculosis or peripneumonia. They 
are very rarely primary in character, and, like the allied forms of 
pleurisy, assume a vegetative and adhesive form in tuberculous cases. 

Moussu has never seen the true exudative form either in acute or 
chronic tuberculosis, but only vegetative and caseous forms. 

Simple acute pericarditis. Cases of simple acute exudative peri- 
carditis have been described, and have been referred to chills, wounds, 
or injuries in the region of the heart, and in a few cases to the 
rheumatic diathesis. 

Such forms of pericarditis may occur, but probably are very rare, 
for Moussu has seen but two cases. As the symptoms correspond 
exactly to those of exudative pericarditis produced by a foreign body, 
it is unnecessary to describe them specially. 

The only important detail to bear in mind wdth this disease is the 
possibility of cure - by suitable treatment, such as the application of 
stimulants or vesicants to the cardiac zone, the administration of sali- 
cylate of soda or diuretics, and complete rest. 

The diagnosis, moreover, should be confirmed by making an aseptic 
exploratory puncture with the capillary trocar. The nature of the 
liquid withdrawn will indicate whether the case is one of simple acute 
pericarditis or pericarditis due to a foreign body. 

Cancerous pericarditis is generally secondary, and is caused by 
development of tumours on the pericardial serous membrane, and in 
the myocardium. Moussu, however, has seen one case of primary 
cancerous pericarditis, the tumours being found only on the periphery 
of the myocardium. The growth assumes a vegetative form with 
moderate exudation. The symptoms, however, so closely approach to 
those of exudative pericarditis due to foreign bodies that only the 



.376 



PERICARDITIS. 



latter variety, which is by far the most frequent in animals of the 
bovine species, need be described. 

EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 

This condition has been erroneously described, as traumatic peri- 
carditis, but the latter term would suggest that the disease was due 
to an injury acting from without. It may be defined as a disease pro- 
duced by the discharge into the peri- 
cardial cavity of some foreign body 
from the gastric compartments. 

Boizy in 1858 described several 
cases of this kind of pericarditis. 
Hamon in 1866 gave an excellent 
table of symptoms. Eoy in 1875 
supplemented this with numerous ob- 
servations showing clearly the pos- 
sibility of recognising the disease by 
clinical examination. Pericarditis due 
to foreign bodies is to-day one of the 
best characterised diseases of the ox, 
and it is easy to diagnose. 

Before approaching the etiological 
side of the question, it is necessary to 
recall in a few words the anatomical 
arrangement of the pericardium and 
its relations to neighbouring organs. 

In the ox the diaphragm pre- 
sents a marked concavity directed to- 
wards the abdomen. The pericardium, 
situated exactly in the median plane, is fixed by its point to the sternum. 
A fold of adipose tissue directjy connects it with the anterior surface of 
the diaphragm. On the abdominal side the conical right compartment 
of the rumen is in free communication with the reticulum, which is 
closely apphed to the posterior surface of the diaphragm on the median 
line opposite the spot occupied by the pericardium on the anterior sur- 
face (Fig. 176). As a result of this arrangement any object passing 
through the reticulum and diaphragm in the median plane would enter 
the pericardial cavity. These particulars indicate clearly how this form 
of pericarditis is produced. 

Causation. One of the chief causes of pericarditis by a foreign body 
is connected with the way in which oxen feed. They rapidly swallow their 
food and any foreign bodies that may be concealed in it, submitting 
it later on to a second mastication in the course of rumination. This 




Fig. 174. — Tumours of the surface of 
the heart. Primary cancerous peri- 
carditis and myocarditis. 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 877 

method of feeding results in bolting the food almost without mastication, 
hence the possibility of swallowing foreign bodies. 

The proximity of the reticulum to the pericardium is also an impor- 
tant factor, because the foreign bodies fall into the reticulum as soon 
as the bolus of food begins to break up. It is important to notice, 
moreover, that pericarditis is commonest on farms where the oxen are 
attended by women, or in regions where sharp objects are to be found on 
roads or pastures frequented by the animals, such as the vicinity of 
needle, nail, and rivet factories. 

The sole cause is the penetration of a foreign body into the peri- 
cardial sac. 

Pathogeny. All kinds of foreign bodies are swallowed by oxen, as 
is abundantly shown by post-mortem examinations. These indigestible 
bodies pass with the food into the rumen, and accumulate in the deepest 
portions of that receptacle. Owing to physiological contractions the 
lower wall of the rumen rises to the level of the orifice of communication 
with the reticulum, and so passes much of the material accumulated 
within it into this organ. 

Soft foreign bodies fall towards the lower parts of the reticulum, but 
sharp objects may lodge in its walls. Very often the bodies penetrate in 
this way without causing reticulitis or grave inflammation. The func- 
tions of the reticulum are not impeded. The commonest of such objects 
are needles, pins, nails, or fragments of iron wire. On account of their 
form, needles are the most dangerous. The sharpness of one extremity 
ensures its passing readily through the tissues, and as the point is 
the part that offers least resistance, the needle continues gradually to 
penetrate. 

If the foreign body becomes implanted vertically in the lower wall of 
the rumen or reticulum it may be expelled directly through the medium 
of an abscess. This is a favourable termination, though it usually 
results in permanent gastric fistula. 

More often the objects penetrate the anterior wall of the reticulum 
and gradually work their way towards the diaphragm, impelled by the 
movements of the reticulum and the other digestive compartments. 
They perforate the muscle and pass into the thoracic cavity, either in 
the direction of the pericardium or of the pleural sacs. 

First as to the penetration of the pericardium. The foreign body, 
whatever it may be, produces by its presence alone very marked irrita- 
tion, and as in addition it is always infected in consequence of its having 
passed through the digestive compartments, inflammation is set up to a 
degree proportionate to the pathogenic qualities of the infective agent. 

Symptoms. The early symptoms are those of indigestion, and not of 
pericardial disease, a fact which is easy to understand, because at first the 



378 PERICAEDITIS. 

whole mischief is in the abdominal cavity. The patients are dull, rest- 
less, and seem to be suffering from an obscure ailment. They remain 
standing more than usual, show more than ordinary deliberation in 
lying down, lose appetite, cease to ruminate regularly, and exhibit 
intermittent tympanites. 

The cause of these symptoms is as follows : At first the reticulum is 
partly immobilised by the local inflammation, and at a later stage move- 
ment of the diaphragm is checked by reflex action when the sharp body 
has progressed far enough to touch it. The rhythmic movements of the 
reticulum and the diaphragm are interfered with, rumination is dis- 
turbed, eructation ceases, and tympanites appears. 

The patient often utters slight groans, particularly when forced to 
move ; but as this is a sign common to all grave diseases it can only 
give rise to a suspicion as to what has occurred. In ten to fifteen days 
this primary phase may have terminated ; but it is impossible to say 
how long it lasts, for it varies with each animal as with each variety 
of foreign body, and it may be prolonged for months. 

From the moment it reaches the thoracic cavity the foreign object 
makes its way towards the channel formed on either side by the ribs and 
below by the sternum, and therefore towards the point of the heart. 
This is the second phase of development. 

The passage of the foreign body through the diaphragm occupies a 
more or less considerable time, depending on its length ; the beginning 
of this second phase is characterised by relative immobility of the circle 
of the hypochondrium during respiration. The abnormal sensibility and 
pain impede contraction of the diaphragm. 

Palpation of the region of the xiphoid cartilage then reveals abnormal 
sensibility, and sometimes causes the animal to resent being handled. 

From this time the pericardial symptoms proper commence, the 
foreign body having come in contact with the pericardium. This phase, 
unlike those which precede it, presents well-defined symptoms. The 
irritation of the heart and its ganglionic system by a foreign body in the 
pericardium is shown by considerable acceleration of the heart beats 
even before there is any exudation into the pericardial sac. Instead of 
60 to 70 beats, the normal number, the pulse may rise to 80, 90, 100, or 
even 110 beats per minute. The heart sounds are tumultuous, dull and 
ill-defined, while the pulse appears bounding and strong. 

But this period of cardiac excitement while persisting is soon com- 
plicated by other symptoms. As soon as the foreign body penetrates the 
pericardial sac, there is infection, which produces an active form of 
inflammation and abundant exudation. From this time the pulse be- 
comes weaker and weaker, until, under the steadily increasing pressure 
on the heart, it is almost imperceptible. 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 379 

There is only moderate fever. As soon as the exudation becomes 
considerable, the sjanptoms of pericarditis grow very marked : they may 
be grouped in the following order, according to their importance. 

A. Cardiac symptoms. On palpation of the cardiac zone on the left 
the impulse of the heart is no longer felt. Percussion, which under 
normal circumstances reveals only partial dulness, now seems to give 
pain, and indicates abnormal dulness distributed in a vertical plane. 
The pulmonary lobes between the pericardium and thoracic walls are 
thrust upwards. The distended pericardial sac approaches the parietal 
layer of the jDleura and may adhere to it, hence the dulness. This dul- 
ness extends as far back as the xiphoid appendix of the sternum, and can 
be detected on both sides, marginated above by a convex line. 

In rare cases the dulness is absent, being partially replaced by tym- 
panitic resonance, due to the presence of gases in the distended peri- 
cardial cavity, which gases originate in the digestive reservoirs or result 
from putrid fermentation of the pericardial exudate. 

Simple or double pleurisy, or even pneumonia of the cardiac lobes 
resulting from infection by contiguity, may complicate cases of rapid 
pericarditis. The dulness then appears modified, as do the signs ob- 
served on auscultation. 

Auscultation furnishes valuable indications. From the outset it re- 
veals acceleration of the heart. At a later stage, but only for a short 
time, it permits of the detection of the pericardial rubbing sound which 
precedes serous exudation, and which may persist for several days when 
large quantities of false membrane are produced. 

If exudate is present in considerable quantities a liquid sound is 
heard at each heart beat. The heart appears to be beating in water, but 
the liquid note varies considerably. It has been termed the " claclaque " 
sound (Lecouturier, 1846), in allusion to the sound produced by the 
meeting of water ripples; '' clapotement " sound (Boizy, 1858), with 
reference to the sound produced under the influence of a light breeze 
on the borders of a stream; " glouglou " sound (Eoy, 1875), suggested 
by the noise of liquid escaping from an inverted bottle into a resonant 
vessel, etc. It is important, however, to remember that cases occur 
(principally when the pericardium is greatly distended and entirely filled 
with liquid) where, with the animal at rest, these sounds are difficult to 
detect. To render them noticeable the patient must be walked for a few 
yards. 

Yernant, again, has described a sound as of dripping water, of quite 
special character ; he compared it to that resulting from the fall of drops 
of liquid on to a marble table or into a half-filled vessel. So far as can 
be ascertained this sound of dripping water greatly resembles that heard 
in pneumo-thorax, but it is less resonant and less prolonged. 



380 



PERICARDITIS. 



It appears to be characteristic of the presence of air in the peri- 
cardial cavity, and its special quality varies with the quantity accumu- 
lated in the pericardium. Masked by these pericardial sounds the 
beating of the heart seems dull, badly defined, distant and stifled. 

B. Jugular symptoms. The ''jugular" symptoms are secondary, 
and result from the accumulation of liquid in the pericardial cavity. 
No intra-pericardial exudate can exist without exerting pressure on the 
heart, and as the auricles have very' thin walls and are more compres- 
sible than the ventricles, this pressure immediately causes difficulty in 
the return circulation, whence venous stasis, varying in intensity, but 

clearly visible and appre- 
ciable on account of the 
distension of the jugulars. 
The venous stasis is 
general, for the pulmonary 
veins are as much com- 
pressed as the posterior 
and anterior venae cavae, 
but it is only apparent in 
the large superficial veins. 
This stasis is accompanied 
by venous pulse, and par- 
ticularly by peripheral or 
internal oedema, oedema of 
the lung, intestine, mesen- 
tery, etc., of the submaxil- 
lary space and of the dewlap 
and entrance to the chest. 
(Edema of the submaxillary 
space is specially charac- 
teristic, for it appears almost 
first amongst external signs. That of the dewlap follows at a later stage, 
and extends backwards as far as the umbilicus, rising above this point as 
high even as the entrance to the chest and the axillary region. 

C. Pulmonary symptoms. The pulmonary symptoms result from 
difficulty in the return circulation and from the venous stasis. They are 
due to passive congestion and oedema of the lung or to hydro -thorax. At 
rest the respiration may appear fairly regular, but at the least movement 
it is accelerated, and may rise to 40 or even 60 per minute. 

Percussion reveals lessened resonance of the parts, and in the case of 
hydro-thorax dulness marginated by a horizontal line, as in pleurisy. 

On auscultation the vesicular murmur may sometimes have dimi- 
nished or even disappeared, while the respiration may be blowing, as in 




Fig. 175. — Appearance of a patient suffering from 
fully-developed pericarditis. 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 381 

active congestion, and in exceptional cases a tubal souffle may be 
observed. In most cases the animal has a paroxysmal, somewhat fre- 
quent cough, due to reflex irritability of the pneumo-gastric. 

Cruzel in addition mentions a double respiratory movement like that 
produced in the horse by broken wind. This is really the result of 
hydro-thorax, and is not a constant symptom. 

D. General symptoms. When the disease has lasted a certain 
time the patients show certain well-marked general symptoms : they 
remain standing in one j)osition for long periods, with the head and 
neck extended, the front legs thrust outwards from the trunk and the 
body rigid, as though the least movement caused them pain. The 
general attitude expresses anxiety, the animals lie down with great care 
and seldom remain long in this position, which interferes with the 
functions of the heart and lung. In the last stages the animals 
remain constantly standing, appetite is almost entirely lost, and they 
waste rapidly. 

The course of pericarditis due to foreign bodies is very variable. 
Sometimes death occurs in eight or ten days. In other cases the animal 
may survive for weeks, provided it is well tended. Everything depends 
on the rapidity with which the foreign body moves and on the character 
of the infectious organisms which it introduces into the pericardium. 
Death is the inevitable termination, and occurs as a consequence of 
cardiac and respiratory syncope. It may follow suddenly as the result 
of a simple forced movement, even when the animal still seems to retain 
some amount of strength. When the organisms introduced into the peri- 
cardium are of marked virulence, complications such as sejDtic pleurisy 
and pneumonia may be observed, and death soon takes place. 

It has been suggested that recovery might follow a return of the 
foreign body towards the reticulum. This view can only have been 
advanced as a consequence of errors in diagnosis, either as to the exist- 
ence of pericarditis or as to its nature. Pericarditis due to cold or rheu- 
matism sometimes becomes cured spontaneously. 

Death, again, may suddenly occur by syncope when the foreign body 
penetrates the myocardium, passes through it, and enters the ventricular 
cavities. 

The return of the foreign body is not conceivable, at all events after 
it arrives in the pericardial cavity. Up to that time the only dis- 
turbance is of a digestive character ; no pericarditis exists. But when 
for example the disturbance is due to long fragments of iron wire which 
may extend from the reticulum as far as the pericardium, it is clear that 
the pericarditis is of a kind which cannot be cured without leaving 
traces. In our opinion, natural recovery is impossible. 

Diagnosis. The diagnosis of pericarditis cannot be made until such 



382 PERICAEDITIS. 

pericarditis actually exists, i.e., until the disease has arrived at the third 
stage of development mentioned above. 

As long as the symptoms point only to the first or second stage, the 
logical diagnosis is reticulitis produced by a foreign body. At this time 
the development of pericarditis, although possible, is not inevitable. 

When, on the other hand, one knows how the digestive disturbance 
has originated and developed and thereafter notes signs of cardiac irrita- 
tion, disappearance of the cardiac impulse, dulness of the heart sounds, 
venous stasis, etc., the diagnosis is easy even thus early. 

Mistakes are not very likely. Only in some cases are they liable to 
occur, as in acute peripneumonia of the anterior pulmonary lobes, 
causing compression of the pericardium of the anterior vena cava and 
producing secondarily venous stasis and oedema of the dewlap. Cases 
of specific pericarditis due to peripneumonia also occur, and under such 
circumstances a mistake would be even more excusable. Nevertheless, 
the temperature curve in itself is a sure indication, for whilst in peri- 
pneumonia the fever is always very marked, it is scarcely noticeable in 
pericarditis due to a foreign body. 

When the diagnosis of pericarditis has been arrived at it is desirable 
to determine the exact nature of the disease, for whilst cases of peri- 
carditis due to foreign bodies are incurable and in the interest of the 
owner the animals should be slaughtered, pericarditis due to cold or 
rheumatism may be successfully treated. Eheumatism generally affects 
the synovial membranes even before it produces pericarditis, and this 
indication, supplemented by the history of the case usually ensures one 
against mistakes regarding the initial cause. 

It is much more difficult to distinguish pericarditis due to a 
foreign body from pericarditis due to carcinoma and from the forms 
of pseudo-pericarditis produced by lesions in the neighbourhood of the 
heart. When considering the latter we shall deal with this particular 
point. 

Prognosis. The prognosis is always fatal. 

Lesions. When the foreign body is very thin and sharp, the reti- 
culum may not become attached to the diaphragm. In such cases its 
passage has been rapid and the tissues have healed. 

Usually the reticulum, diaphragm and pericardium are united by a 
mass of fibrous tissue as thick as a man's arm. It resembles a fibrous 
sleeve surrounded by an oedematus zone, usually of slight extent. This 
mass of new fibrous tissue is traversed by a sinuous tract resulting from 
the irritant action of the foreign body on the surrounding tissues. All 
writers describe this fibrous sleeve, which, however, only occurs in cases 
where a very long foreign body has occupied a considerable time in pass- 
ing from the reticulum to the cavity of the chest. 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 



383 



In very exceptional cases the sinuous tract is ramified, possibly as a 
result of displacements of the foreign body. 

The orifices of the tract are to be found, one in the reticulum, the 
other in the pericardium. On the side of the reticulum there is never 
more than one opening, and in many instances the tract is already closed 
on that side, either by exuberant granulations or by a cicatrix. 

On the contrary, the fistula is more frequently open in the pericardial 
cavity. Its walls are of very varying appearance, depending on their age : 




Fig. 176. — Appearance of the lesions in a case of fatal pericarditis. P, inflamed peri- 
cardium, distended with exudate and adherent to the neighbouring pulmonary lobes ; 
I , posterior lobe ; 2, cardiac lobe ; 3, anterior lobe ; Fp, pleural false membranes. 



they may be red, greyish, soft or hard, and when the lesion is of old 
standing they may have been converted into a sclerotic tissue. 

The pericardium appears distended with a considerable quantity of 
liquid of a special character — sometimes sero-sanguinolent, sometimes 
almost or entirely purulent ; sometimes yellowish, or greenish-grey ; 
sometimes frothy, inodorous, or very foetid. 

These characters depend on the nature and number of the germs 
which have invaded the pericardial cavity. They also vary with the 
gravity and number of the haemorrhages produced by the action of the 
foreign body on the myocardium. 



884 PERICARDITIS. 

The quantity of liquid also varies within very wide limits. There 
may be scarcely any exudation. In that case the pericarditis is of a 
partially adhesive character, with abundant false membranes. As a 
rule the quantity of fluid exudation varies between seven and eight 
quarts, but sometimes the quantity is much greater. Trasbot de- 
scribed an instance in which the united weights of the heart and peri- 
cardium exceeded 36 lbs. Hamon mentioned a case of pericarditis in 
which the liquid exudate exceeded twenty quarts. 

"When inflammation is first set up the liquid is serous, yellowish, 
or reddish-yellow. It contains fibrinous flocculi in suspension. Little 
by little this exudate becomes purulent, whilst the internal layers of the 
pericardial serous membrane undergo desquamation. These are next 
covered with false membranes of varying appearance ; the fibro-albu- 
minous exudation is wrinkled, villous and tufted. The two layers of 
serous membrane are connected at certain points by this exudation, the 
adhesions being sometimes very extensive. The pericardial sac pro- 
perly so called becomes the seat of marked lardaceous thickening, due 
to inflammation. The heart appears entirely covered with a layer of 
greyish or earthy-coloured granulation tissue, which appears as though 
baked, and was compared by Hamon to the back of a toad. It is atro- 
phied as a consequence of prolonged compression. 

Under the influence of the excentric pressure of the liquid the peri- 
cardial sac is distended and comes in contact with the walls of the chest, 
to which it may adhere. The foreign body, especially if small, is not 
always easy to find. 

The myocardium often displays interesting lesions. At first there is 
thickening, or more commonly sclerous degeneration, of the superficial 
layers covering the ventricles, and then appears a crop of little miliary 
abscesses. Abscesses of considerable size have several times been 
detected in the walls of the ventricles and in the interventricular 
sejDtum. 

The foreign body, moreover, may not only injure the myocardium, 
but may even perforate it completely and produce ulcerative endocarditis 
(Cadeac). In this case infectious germs very rapidly invade the circu- 
lation and all the tissues, and the animal dies of pyaemia. 

These essential lesions are accompanied by others of varying im- 
portance. Thus the lung is congested throughout, and by contiguity 
of tissue inflammation ma}^ extend from the pericardium to the lower 
part of the pulmonary lobes and to the pleura. 

Interference wdth the return circulation induces lesions due to venous 
stasis : dropsy of the chief serous membranes, oedema of the connective 
tissue, pleural and 'peritoneal exudations, etc. If the hind limbs never 
become swollen it is because the skin covering them is very resistant 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 385 

and does not readil}^ yield. The liver becomes hypertrophied, congested 
and engorged with blood, and when the animals live for some weeks, 
shows the appearances known as cardiac or nutmeg liver. 

Treatment. The treatment of pericarditis due to the presence of 
foreign bodies is at present merely palliative. Often the only thing 
to be done is to slaughter the animal. 

We need not go back to the methods formerly recommended. All 
are illusory or mischievous, such as the use of purgatives to arrest or 
reverse the progress of the foreign body, removal of the foreign body 
after opening the rumen, j^uncture of the pericardium, etc. 

In 1878 Bastin successfully opened the pericardium and extracted 
the foreign body through a window produced in the thoracic w^all. 

This operator recommends that after drawing the left limb forward 
and incising the skin and muscles, the operator, with his hand bound 
round with a cloth, should perforate the pleura, and then having found 
the foreign body, proceed to extract it. By this method it seems difficult 
to cause perforation of the pericardium, which would certainly lead to 
the production of pneumo-thorax complicated with fatal septic pleurisy. 

It must be borne in mind that the two pleural sacs, right and left, 
descend as far as the sternum (Fig. 173), and that it is not possible to 
touch the pericardium directly without perforating the pleura. 

Moussu has drained the pericardium through the pleura in the hope 
of relieving the pressure on the heart and facilitating the reabsorption of 
the oedema, in order to permit of the subsequent slaughter of the animal, 
but has had unsatisfactory results. Lastly, he has practised median 
trepanation of the sternum in the infra-pericardiac region. Here again 
the operation is difficult, because of the oedematous infiltration of all the 
substernal region, while it is so dangerous to the patient, which must be 
cast and may suddenly succumb, that it is of no use in ordinary practice. 

There is probably only one condition in which it would be possible to 
attempt intervention with a fair chance of success, that is, when there 
exists a fibrous connection between the pericardium, lung, and wall of 
the chest on the right or left side. 

In such cases aspiratory puncture or incision of the pericardium in 
an intercostal space might prove of service, because it would not expose 
the animal to the danger of pneumo-thorax. 

The only difficulty lies in ascertaining beyond all question the existence 
of such an adhesion before attempting operation, and this is really very 
great, even having regard to the form of the dulness and the absence of 
all respiratory sound in the lower third of the thoracic cavity and cardiac 
zone. The pulmonary lobe between the heart and chest wall may be 
thrust upwards and be partially adherent to the pericardium and to the 
parietal pleura, and at the same time it may be im^DOssible to avoid 
D.c. c c 



386 



PERICARDITIS. 



producing operative pneumo-thorax when the cartilages are resected to 
admit of incising the pericardium. 

The only logical method seems to be puncture of the pericardium 
through the xiphoid cartilage, as described below. 

The topographical anatomy of the thoracic viscera shows that the 
point of the pericardium extends along the sternum to a point close to 
the lower insertion of the diaphragm, and that the pericardial sac is 




F. Ax. F. 



Fig. 177. — Lesions of exudative pericarditis produced by a foreign body. Eelation 
of the pericardium to the sternum and ensiform cartilage. Pericardium opened. 
D, diaphragm ; Oil, oedema of the dewlap, Kx, ensiform cartilage ; F, liver ; V&, gall 
bladder ; 1, posterior lobe of the lung, drawn backwards ; 2, cardiac lobe ; 3, anterior 
lobe ; E, spot where the foreign body penetrated, towards the point of the peri- 
cardium, between the neck of the ensiform cartilage and the circle of the hypo- 
chondrium. 



only separated from the xiphoid region, or rather from the region of the 
neck of the xiphoid appendix of the sternum, by the fatty cushion at the 
point of the heart. 

A glance at the annexed diagram (Fig. 177) will show this. 

The diagram, carefully reproduced from an anatomical preparation of 
an animal which succumbed to pericarditis, shows that the distended 
pericardium extends close to the neck of the xiphoid cartilage. 

First stage. Identify the three following anatomical guiding points : — 

(1.) Xiphoid appendix and white line. (2.) Point at which the circle of 



EXUDATIVE PERICARDITIS DUE TO FOREIGN BODIES. 



387 



the hypochondrium becomes attached to the sternum. (3.) Point at which 
the external mammary vem penetrates the abdominal wall (Fig. 178). 

Lines uniting these three points enclose a right-angled triangle, which 
the operator must imagine to be bisected by a third line. 

The incision, which should be about 8 inches in length, follows this 
bisecting line at an equal distance between the white line and the circle 
of the hypochondrium, to a point within about 8 inches of the anterior 
margin of the mamma. All these points are readily observable before 
the animal is cast. 

The cutaneous incision affords exit to large quantities of fluid, and the 



VM.a. 




L3. 

Fig. 178. — Seat of operation for puncturing the pericardium by way of tlie ensiform 
cartilage. L B, AVhite line; H, line of the hypochondrium; Y.M.a., anterior 
mammary vein ; P, point where the pericardium is punctured through the incision. 



pectoral muscles attached to the neck of the ensiform cartilage can then 
be divided with the bistoury. The area of operation is thus uncovered. 

Second stage. The second phase comprises incision of the tissues 
opposite the neck of the ensiform cartilage, about 8 inches in front of 
the base of the triangle and at equal distances from the points Nos. 1 
and 2; incision through the skin for a distance of 8 inches, and dis- 
section of the muscles of the ensiform region exposed at the neck of the 
cartilage. 

By means of the index finger or the index and middle fingers of the 
right hand the mediastinal space is explored, and the fatty masses round 
the base of the heart broken through. If the pericardium is greatly 
distended, the point of the sac can be felt wdth the tip of the finger, or 
its position can be recognised, even from a little distance, on account of 
the fluid contents transmitting the impulse of the heart. The sensation 
conveyed to the finger is very clear. 

c c 2 



388 



PERICARDITIS. 



The right index finger is then replaced by the left, and, a trocar about 
10 inches long and J inch in diameter being introduced along the index 
finger used as a director, the pericardial sac is reached. The exudative 
fluid transmits the impulse due to the beating of the heart, and the 
pulsations can be clearly distinguished when grasping the handle of 
the trocar. 

Third stage. Digital exploration of the course of the puncture and 
fatty cushion at the base of the heart, with the object of discovering the 
position of the pericardium. 

Fourth stage. Puncture with a trocar about 10 to 12 inches in 
length, jDuncture of the pericardium, irrigation and dressing. 

The trocar is inclined in a slightly oblique direction from without 




Fig. 179.^ — Photograph of a patient immediately after operation, 
oedema of the dewlap and neck. 



Extensive 



inwards and forwards towards the median plane, in order that the point 
may not deviate towards the left pleural sac ; the left index finger is then 
withdrawn, and by a sharp thrust of the right hand the trocar is pushed 
forward about 1 to IJ inches and the pericardial sac is entered. 

The position of the canula should not be altered whilst liquid is 
escaping, for if it is thrust in too far a considerable quantity of fluid 
may remain in the deepest portion of the sac. 

The cavity having been drained, a long strip of iodoform gauze is intro- 
duced into the track and a protective surgical dressing applied over the 
incision in order to prevent infection by the litter. 

In consequence of the introduction of the fingers into the track caused 
by puncture and the escape of pericardial liquid along the canula or after 
removal of the canula, the operative wound is necessarily infected ; but this 



CilRONlC PERICARDITIS. 



389 



is of little importance, because the opening is inclined downwards, 
and also because it is impossible to hope for aseptic healing. 

The dressing is renewed after forty-eight hours, and every three or 
four days afterwards. 

The oedematous infiltration about the front portion of the body 
disappears rapidly in two to three days, and should the animal be 
slaughtered the meat is quite sound in gippearance. 

This operation does not aim at effecting a cure, but is simply for the 
purpose of allowing animals which would otherwise be valueless to be 
slaughtered and sold. 

CHRONIC PERICARDITIS. 

Pericarditis when due to tuberculosis may assume the chronic form. 
Tuberculous pericarditis, at least in a large number of cases, is only accom- 




FiG. 180. ^Photograph of the same subject as Fig. 179, taken six days later. 

panied by slight exudation, which might remain unnoticed unless the 
animals were carefully examined; but it causes the internal surface of the 
pericardial sac and the surface of the myocardium to become covered 
with exuberant vascular growths, which by setting up adhesions lead to 
partial or generalised union of the heart and pericardial sac. Between 
these adhesions, which form partitions, are found little cavities filled 
with sero-sanguinolent, grumous, or caseous liquid. In time the ad- 
hesions increase in number, pericarditis obliterates the free space, and 
the heart becomes wholly adherent to the pericardium. 

As in acute pericarditis, the fibrous layer undergoes thickening and 
hardening processes. The superficial layers of the myocardium undergo 
sclerous transformation, and the tissues forming the adhesions them- 
selves may assume the characters of fibrous tissue. 



890 



PERitiARDiTiS. 



In one solitary case Moussu saw another form of chronic pericarditis 
with complete adhesion of the heart and pericardial sac, without any 
exudation and almost without any false membranes. He was unable to 
determine the exact cause, but was strongly inclined to regard the disease 
as having followed pericarditis a frigore or pericarditis of a rheumatic 
character. 

Adhesions between the heart and pericardial sac are also said to be 
the inevitable though delayed result of all punctures of the peri- 
cardium through the ensiform carti- 
lage in cases of pericarditis due to 
a foreign body. 

Symptoms. If the chronic peri- 
carditis is limited to a few partial 
adhesions, it remains unnoticed 5 
but when it is more marked it offers 
certain signs of acute pericarditis, 
such as partial dulness of the car- 
diac area, which is more extensive 
than usual, disappearance of the 
cardiac shock, weakening of the 
sounds, feebleness of the pulse, 
very marked venous pulse, moderate 
stasis, extremely rapid and aggra- 
vated dyspnoea when the animal is 
forced to walk, threatened asphyxia 
if exercise is prolonged, and com- 
plete asystole. 

All these symptoms are due to 
the existence of adhesions between 
the heart and pericardium, which, 
by destroying the interpericardial 
space, interfere with diastole while 




Fig. 181. — Schema of a subpleural 
abscess on the right side which pro- 
duced symptoms of pericarditis (pseudo- 
pericarditis) . To, Eight lung, partly 
splenised and thrust upwards ; PZ, 
parietal pleura separated from the wall 
of the lower half of the chest ; A, cavity 
of the subpleural abscess. 



preventing regular systole. 

Sudden death is a frequent consequence. 

The diagnosis of chronic pericarditis is very difficult. The prognosis 
is extremely grave, and we do not possess any means of dealing with the 
condition. 

PSEUDO-PERICARDITIS, 

Under this title we purpose grouping a certain number of pathological 
accidents due to different causes, but manifesting themselves by identical 
symptoms, which symptoms offer so marked a resemblance to those of 
pericarditis produced by foreign bodies as to suggest the presence of that 



PSEUDO-PERICARDITIS. 891 

disease. This refers to accidents by which the foreign body closely 
approaches, without actually touching, the pericardium, the lung or the 
pleural sacs, but in which it causes purulent collections which displace 
the pericardium, indirectly compress the heart, and finally cause symp- 
toms of an apparently pericardial character. 

Causation. During the development of pericarditis the foreign body 
perforates the reticulum and diaphragm, passing along the middle line 
of the body, without which it would not come in contact with the peri- 
cardium. If the perforation, however, occurs to the right or left of the 
median plane, the foreign body moves forward just as easily, but it 
misses the pericardium and passes either into the lung, where it causes 
fatal pneumonia ; or the pleura, where either it sets up septic pleurisy 
in the subpleural connective tissue or produces an abscess. 

The abscess is generally lateral, situated in the right subpleural 
region, or it may develop below the pericardium. These are the two 
varieties of pseudo-pericarditis seen by Moussu. 

There is, however, a third variety, which might be called " parasitic 
pseudo-pericarditis." It is extremely rare, and Moussu has only seen 
one case. It was due to the presence of an enormous hydatid cyst of the 
right lung as large as a man's head, which was situated towards the 
mediastinal plane of the lung and pressed on the supero-posterior sur- 
face of the heart and pericardium. In consequence of the permanent 
downward pressure which it exercised it interfered seriously with the 
heart's action and caused symptoms of pseudo-pericarditis. 

Symptoms. The general and external symptoms are those of peri- 
carditis — viz., dulness, diminution in appetite, irregular rumination, 
wasting, oedema of the dewlap, distension of the jugulars, marked 
venous pulse, great anxiety and dyspnoea when the patients are forced 
to move, etc. 

But the cardiac symptoms differ notably, and moreover vary, accord- 
ing to the nature of the lesions. Speaking generally percussion reveals 
complete dulness on one or both sides, and auscultation always indicates 
the absence of sounds due to extravasated fluid in the pericardial sac. 

When the abscess is situated below the pericardium, a condition 
difficult to diagnose, the dulness seldom extends very high on either 
side of the chest, and the sounds heard over the cardiac area, while 
much weaker than usual, are audible above the normal points. 

An abscess developing beneath the pleura on one side displaces the 
heart in the opposite direction. The cardiac beat is weakened by the 
compression, but, nevertheless, transmits an impulse to the purulent 
fluid, which in its turn conveys it outwards through the intercostal 
spaces in the form of movements corresponding in rhythm with the 
beating of the heart, so that at first glance one might imagine an 



892 



Pericarditis. 



aneurism existed at the base of the large arterial trunks. The lower pul- 
monary lobe is thrust upwards, and over the area of dulness pulmonary 
sounds completely disappear. 

When the heart is compressed by a large hydatid cyst or other lesion, 
the general and external symptoms are similar to those above described. 

Finally, one last symptom, which appears of some importance, may be 
mentioned. When animals suffering from pericarditis due to a foreign 
body are forced to move, the beating of the heart becomes so tumultuous 
that it can no longer be counted, and even in a state of rest it may rise to 




Fig. 182.— Appearance of an animal suffering from pseudo-pericarditis (infra- 
pericardial abscess). The dotted outline indicates the space occupied by 
the heart, which is thrust upwards. 



140 or 150 beats per minute. In cases of pseudo-pericarditis it rarely 
rises above 90 or 110. 

Diagnosis. The attempt to diagnose this condition accurately must 
not be regarded merely as a result of scientific curiosity. Under certain 
circumstances the diagnosis may be of very great importance. While 
the patient affected with pericarditis due to a foreign body is beyond 
all hope of recovery, certain cases of pseudo-pericarditis appear amenable 
to treatment. 

The diagnosis, therefore, is of great importance, and the practitioner 
should spare no effort to confirm it, bearing in mind the symptoms 
enumerated, and remembering that the normal sounds of the heart 
never completely disappear. 

An aseptic exploratory puncture with a long, fine needle will some- 
times prove of great assistance. 



PSEUDO-PfiRICARDITlS. S93 

Prognosis. Although grave, the prognosis is less so than in true 
pericarditis. 

Treatment. If clearly recognised, both subpleural and subperi- 
cardial abscesses seem curable. By freely puncturing the pus- filled 
cavity through an intercostal space, the liquid may be evacuated and 
recovery may occur. Healing is favoured by carefully washing out the 
cavity with a non-irritant disinfectant. 

The only precaution required in making such punctures is to avoid 
the internal thoracic artery and vein, the intercostal artery, and the 
lower cul-de-sac of the pleura. 



CHAPTER III. 
ENDOCARDITIS, 

If the symptoms of pericardial diseases are well defined, we cannot 
say the same of diseases of the heart, properly so-called. Such affections 
often pass unnoticed, being detected only on post-mortem examination. 
Moreover, cardiac diseases are rare. Very frequently they are only of a 
secondary nature, accompanying or following better recognised condi- 
tions, such as infectious diseases, post-partum infections, etc. 

Causation. Endocarditis, i.e., inflammation of the endocardium and 
valves, is rarely primary, simple and benign. It was formerly thought to 
be the result of chills or of the rheumatic diathesis. These simple forms 
of endocarditis usually escaj^e observation, though careful examination in 
the first instance reveals them. 

Much more frequently, however, endocarditis is secondary, malignant, 
infectious and infecting. This variety occurs as a complication of post- 
partum infection or of very serious general conditions, such as peri- 
pneumonia, gangrenous coryza, aphthous fever, tuberculosis, etc. To 
detect it, not only must the original disease be accurately diagnosed, but 
all the changes the disease is producing in important organs must be 
followed. 

While it is generally admitted that all forms of endocarditis, even of 
the most benign character, are originally due to infection, it is certain that 
in those of the second group the organisms which have entered the blood- 
stream through a lesion of the uterus, lung or other tissue, are endowed 
with very great virulence. They attack some point on the endocardium, 
and produce either ulcerations which become covered with fibrous clots, 
or exuberant new growths of a pathological nature, which generally are 
papilliform, fragile, and prone to become detached by rupture of their 
pedicle and thus to be launched into the general circulation and to form 
emboli. The surface of these infected vegetations, like that of the ulcera- 
tions, becomes covered with fibrinous clots, which are readily loosened, 
form emboli in their turn, and infect distant organs. 

Symptoms. The general symptoms of infectious endocarditis are by 
far the most important. They consist of prostration, loss of appetite, 
severe thirst, and high temperature. The local symptoms consist 



ENDOCARDITIS. 305 

principally of murmurs : soft murmurs due to insufficiency of the 
auriculo-ventricular valves, heard during systole, particularly opposite 
the point of the heart where the cardiac shock is most clearly felt. This 
fact differentiates them from the murmurs of chronic endocarditis, 
which are usually due to aortic contraction, and are accompanied by a 
systolic sound heard at the base of the heart, more in advance and at 
a higher point than those now under consideration. 

These murmurs or souffles furthermore vary in intensity and in 
character, according to whether the endocarditis results from post- 
partum infection, pysemic disease, or some other cause. 

Diagnosis. The diagnosis of endocarditis has not yet been the 
object of really careful study in bovine pathology, but there is no doubt 
that it can often be detected by patient examination. 

Prognosis. The prognosis is very grave, and patients may die in 
a few days. 

Treatment comprises vigorous local stimulation over the cardiac 
area, the administration of antithermic and antiseptic drugs, such as 
salicylate of soda, or of digitalis, sparteine or other cardiac tonics. 

Pathologists have also described, chiefly as post-mortem curiosities 
of interest to pathological anatomists, various diseases and lesions due 
to insufficiency or contraction of the auriculo-ventricular, aortic, and 
pulmonary openings, lesions due to infectious myocarditis, to the pre- 
sence of parasites and to other causes. 

The symptoms of these various diseases or lesions in bovine 
animals are still too imperfectly understood to permit of more than 
a very limited description. 

In the present state of our knowledge, diagnosis would alw^ays be 
of an uncertain character, and for this reason we do not propose to 
deal with them at present. 



CHAPTER IV. 

DISEASES OF BLOOD-VESSELS. 

Diseases of vessels, arteries or veins, in animals of the bovine and 
ovine species are frequently nothing more than localisations of grave 
general disorders, and rarely admit of treatment. This is specially the 
case in regard to arteries, but a study of the diseases of veins has some 
practical importance. 

PHLEBITIS, 

Phlebitis, i.e., inflammation of a vein, is of interest only in the case 
of bovine animals. In them certain conditions may occur which the 
practitioner should understand, with a view either to prevention or treat- 
ment. Inflammation of the veins may be due to external causes, such as 
surgical or accidental wounds (phlebotomy wounds, accidental wounds, 
local inflammations, etc.), or to internal causes of infectious origin 
(general infection, puerperal infection, etc.). 

ACCIDENTAL PHLEBITIS. 

The jugular vein may become inflamed as a result of accidental 
wounds or of phlebotomy, but the mammary vein in cows is much more 
frequently affected. In both cases the disease is due to infection of the 
clot which seals the vessel ; it may assume the form of either adhesive 
phlebitis or suppurative phlebitis. Whether produced directly by the use 
of infected instruments or whether it is of a secondary character, trace- 
able to the clot being infected by germs entering from without being 
conveyed to the wounds by the head-stall chains, by litter, manure, etc., 
the result is the same. The inflammation, at first confined to the 
endothelium, extends to the wall of the vein and causes fibrin to be 
precipitated over the inner wall of the inflamed vein for a distance 
varying with each case. 

If the micro-organisms do not produce suppuration, the vein appears 
simply thrombosed and inflamed, the phlebitis remains of an adhesive 
character, and maiy disappear spontaneously, provided the animal be kept 
quiet. If, on the other hand, suppuration is set up, the clot gradually 
breaks down, the internal surface of the vein develops granulations and 



ACCIDENTAL PHLEBITIS. 397 

undergoes suppuration, and the phlebitis is then said to become suppura- 
tive. The clot may even become entirely detached, transforming the 
snj)purative phlebitis into a very grave form of hsemorrhagic phlebitis. 

The jugular is the commonest seat of adhesive phlebitis, the mam- 
mary vein of suppurative phlebitis. 

Symptoms. The symptoms are easy to recognise. The accidental or 
instrumental wound is the seat of a painful oedematous swelling. It dis- 
charges a reddish offensive serosity, or exhibits blackish-violet bleeding 
granulations surrounding a little central sinus. 

The affected vein, whether the jugular or mammary, soon becomes 
swollen, is sensitive to the touch and very rapidly becomes indurated 
in the direction of its origin for a greater or less distance. 

Phlebitis has then set in, and according as one or other complication 
predominates, it is described as suppurative or hsemorrhagic. 

Diagnosis and prognosis. The diagnosis presents no difficulty. In 
phlebitis of the jugular the neck is held stiffly, and the jugular furrow is 
partly obliterated. 

The prognosis is somewhat serious, particularly in phlebitis of the 
mammary vein, for obliteration of the vein interferes with the function 
of the venous plexus from which it springs, and, although there may 
be a limited vicarious circulation, the secretion of milk is indirectly and 
secondarily checked owing to difficulty of irrigation. 

The extension of phlebitis of the jugular towards the head and the 
venous sinuses of the cranial cavity, is quite exceptional. 

When the mammary vein is inflamed it appears collapsed in the 
direction of the heart and sw^oUen, indurated, and painful in that of 
its origin in the mammary gland. 

Treatment. The first point requiring attention is so to fix the 
animal as to prevent the clot from being pressed upon or crushed, 
though, unfortunately, this cannot always be properly done. The diffi- 
culty is obviated by applying vesicants, which cause swelling and pain, 
and so reduce natural movement of the parts to a minimum. 

At first, when the parts surrounding the operative wound are simply 
swollen and phlebitis is threatened, repeated application of tincture 
of iodine or a liquid vesicant is useful, and may prevent the disease 
developing. 

In existing cases a blister applied over and around the whole of 
the hardened tract may prevent the mischief from proceeding beyond 
the adhesive stage. In such case the clot becomes organised, the vein 
remains obliterated, and recovery follows. 

Similar treatment may also be employed in suppurative phlebitis, 
but as the clot gradually breaks down in consequence of the action of 
bacteria it is useful and almost indispensable to disinfect the vessel. For 



398 DISEASES OF BLOOD-VESSELS. 

this purpose the opening of the sinus must be enlarged, and, by means of 
a sterilised or very clean syringe with a curved nozzle, the parts washed 
out daily with warm boiled water, followed by an antiseptic injection 
containing 2 per thousand of iodine, 3 per cent, of carbolic acid, or, 
better still, glycerine containing 1 per thousand of sublimate. 

If in spite of this treatment the phlebitis extends towards the origin 
of the jugular or mammary vein, a counter-opening may be made at the 
point where the clot still remains adherent, and a strip of iodoform gauze 
saturated with tincture of iodine or with blistering ointment diluted to 
one-eighth with oil may be passed. Needle firing is also of value. 
Finally, as a last resource, a ligature may be applied to the vein above 
or beyond the clot. 

This operation, which in the horse is confined to haemorrhagic 
phlebitis, is especially applicable to phlebitis of the mammary vein in 
the cow. As the vein is subcutaneous, the operation may easily be 
performed in the standing position ; the successive stages are as 
follows : — 

The patient is firmly secured and its hind limbs hobbled by passing 
a rope around the hocks in a figure of eight. It is steadied on one 
side by an assistant who presses on the quarter. 

One cubic centimetre of a 10 per cent, solution of cocaine is sub- 
cutaneously injected on each side of the vein at the point chosen. Ten 
minutes later a button-hole incision is made through the skin and a loop 
of thick catgut passed around the vein by means of a curved needle. 
The ligature is tied firmly with a surgical knot and the little wound 
afterwards covered with a mass of cotton wool secured by collodion. 

INTERNAL INFECTIOUS PHLEBITIS (UTERO- OVARIAN PHLEBITIS). 

The internal forms of phlebitis of parasitic or infectious origin are as 
yet little understood, but mention may be made of phlebitis of the utero- 
ovarian veins which frequently follows parturition and post-partum in- 
fection. This is probably in many instances the real cause of the post- 
partum paraplegia without gross or apparent material lesions. 

This form of infectious phlebitis may extend to the large internal and 
external iliac veins and produce embolism and septicaemia, as is shown 
by recorded cases. 

The mechanism of the disease is easily understood. The infective 
agents penetrate the veins of the uterine mucous membrane and pass 
from the lumen into the wall of the vein. Here they cause inflammation 
of the vascular endothelium, followed by the deposit of a fibrous clot of 
cylindrical form, which sets up partial thrombosis of the vein. This 
thrombosis becomes complete by the formation of a central clot due 
to venous stasis. 



UMBILICAL PHLEBITIS OF NEW-BORN ANIMALS. 399 

It is not necessary for the germs to penetrate at a number of points. 
The thrombosis progresses until it gains a large trunk beyond the 
original point of infection. 

Symptoms. Phlebitis of the veins of the pelvis is frequently mis- 
understood or overlooked, because the practitioner is apt to confine his 
attention to external signs, the paresis and paraplegia of the hind 
quarters. 

The symptoms usually appear from five to eight days after normal 
parturition or parturition in which there is retention of the after-birth 
followed by metritis. The animals show fever and lose appetite, signs 
which may be due to metritis, but soon after they experience difficulty 
in rising, and some days later remain permanently recumbent. 

The circulation is weak, and the entire intra-pelvic region painful; 
the large nervous trunks are affected, exertion becomes difficult, and the 
animals refuse to rise. At this stage they should not be forced to do so. 
In two to three weeks improvement may occur and lead to recovery 
but in many instances various complications in the nature of purulent 
infection or septicaemia set in, or the animals are previously slaughtered. 
Diagnosis. The diagnosis can only be determined after the symp- 
toms develop. Confirmation might in some cases be obtained by 
rectal exploration made methodically and gently. 
Prognosis. The prognosis is grave. 

Treatment. Treatment should be based on disinfection of the uterus 
by injections of boiled water or warm iodised solutions and drainage by 
means of strips of iodoform gauze. The animals should be placed on a 
thick and scrupulously clean bed, and as far as possible be spared any 
considerable exertion for a fortnight. By changing their position once 
or twice a day complications ma}^ be avoided. 



UMBILICAL PHLEBITIS OF NEW-BORN ANIMALS. 

One of the most serious conditions met with in practice is that 
known as umbilical phlebitis of new-born animals. Whilst in fact it is 
easy to deal with phlebitis of the jugular or mammary vein, surgical or 
medical assistance becomes extremely difficult in this case, because the 
inflamed vein is deeply situated in the abdomen and passes through one 
of the most important internal organs, viz., the liver. When it is added 
that umbilical phlebitis is in 95 per cent, of cases of a suppurative 
character, the reader may form some idea of its gravity. 

Unless the condition is early diagnosed and measures are at once 
taken, such complications as infectious hepatitis, purulent infection, 
and septicaemia cannot be avoided. Death is then inevitable. 

In order clearly to understand this phlebitis, however, it is necessary 



400 



DISEASES OF BLOOD-VESSELS. 



to recall the anatomical formation of the umbilical region in the new- 
born animal. 

At birth the mnbilical cord is represented by a cylindrical mass, 
surrounded by the terminal portion of the amnion. It enters the 
abdomen through a circular perforation in the abdominal wall known 
as the umbilical ring. This ring may be divided into two parts, one 
deeply seated, the fibro-aponeurotic ring, consisting of an aperture in 




Fig. 183. — Position of tlie abdominal viscera in a new-born annual : Hn, rumen ; 
E, epiploon; E^, left kidney; Ig, small intestine; C, abomasum ; U, m^eter ; 
O, uraclms ; R, rectmn. Umbilical cord : Vo, Umbilical vein ; A<x, allantoid 
arteries ; V«, allantoid veins ; 0, the urachus. 



the white line ; the other the superficial or cutaneous ring, formed 
by the skin, which is wrinkled all round it, and constitutes a kind of 
sleeve about an inch in length. This cutaneous sleeve is continuous 
with the amniotic tissues. The entire umbilical cord is therefore 
enveloped in an amniotic-cutaneous sheath. 

It is composed of four principal structures — the umbilical arteries, 
the umbilical vein, the urachus, and the interstitial mucous tissue. 

The umbilical arteries and vein consist of two parts — the extra-foetal 
part, which co-operates in forming the cord, and the intra-foetal part. 



UMBILICAL PHLEBITIS OF NEW-BOEN ANIMALS. 401 

The first is formed of two arteries and two veins, in contra-dis- 
tinction to the condition in soHpeds, where the cord only contains one 
vein. In the second, the arrangement is as follows : The two umbilical 
allantoid arteries on entering the abdomen cm^ve backwards towards the 
entry of the pelvis, passing over the sides of the bladder enveloped in 
the lateral ligaments, and extend upwards towards the bifmxation of the 
aorta, finally pouring their contents into the internal iliac arteries. In 
the adult they may still be traced as annexes of these latter vessels. 
The two umbilical veins on passing through the ring unite to form one 
within the abdomen. This vessel passes forw^ards, rising along the 
lower abdominal wall, then becomes lodged in the thickness of the 
inferior middle ligament of the liver, and finally penetrates that organ 
where it unites with the portal vein. It is also connected with a vessel 
known as " the vein of Arantius," which places it in communication with 
the posterior vena cava, a vein not found in solipeds. 

The foetal blood is purified by exchanges between it and that circu- 
lating in the maternal placenta, and when re-arterialised it returns by 
the umbilical vein. 

The urachus, found in the embryo and foetus, eventually gives rise 
to the bladder. In new-born animals this viscus is therefore open at 
its base, and communicates with the allantoid cavity through the 
urachus. The urachus starts from the base of the bladder, and, extend- 
ing along the median plane of the lower abdominal w^all between the two 
umbilical arteries as far as the umbilical opening, takes its place in the 
cord alongside the vessels. Through it the secretions of the foetal 
kidneys drain into the allantoid cavity. The interstitial mucous tissue, 
also called " Wharton's jelly," is a gelatinous material which unites 
these different vessels and helps to support and protect them in the 
umbilical cord. It is particularly abundant opposite the umbilicus. 

Immediately after birth the umbilical cord ruptures of itself as a 
result of the fall which the young animal ex^^eriences or of movements 
made by the mother, as for instance when she attempts to rise. In 
certain other cases it is divided by the mother biting it, or it may be 
ligatured by some person present. However the rupture may be 
brought about, it always occurs at a distance of 2 to 4 inches from the 
umbilicus. The immediate result is to produce thrombosis of the 
umbilical vessels and obstruction of the urachus. The two umbilical 
arteries rarely bleed, for hsemostasis is brought about by stretching, 
and these arteries, being very elastic, almost immediately retract and 
close. The umbilical veins simultaneously become blocked, and the 
single intra-abdominal vein having no further raisoii cVetre, gradually 
becomes obliterated. The urachus should normally be obliterated at 
the moment of delivery (Colin and Saint-Cyr), or at any rate soon 

D.C. D D 



402 DISEASES OF BLOOD-VESSELS. 

afterwards, as a consequence of rupture of the cord (Chauveau and 
Zundel). 

Immediately after delivery another change sets in. The extra-foetal 
portion of the cord, which remains attached to the umbilicus, dries on 
contact with the air, the Wharton's jelly retracts, the whole undergoes 
a kind of necrosis, assumes the appearance of a dry scab, and in eight or 
ten days falls away, leaving in its place the umbilicus, which should be 
half cicatrised on the fall of the cord. Thus the umbilical cord presents 
an extra-foetal degenerated portion and a persistent portion about J to 
1 inch only in length, buried in the cutaneous ring of the umbilical 
region. 

If all the changes indicated occur normally and physiologically, the 
little w^ound in the region of the umbilicus cicatrises in a perfectly 
regular way. But unfortunately this is not always the case. At times 
the cicatrix becomes contaminated by manure, urine or dust, suppurates, 
and may then become the seat of various complications, such as um- 
bilical phlebitis, omphalitis or persistence of the canal of the urachus. 

UMBILICAL PHLEBITIS OR OMPHALO-PHLEBITIS. 

History. Umbilical phlebitis, and in a more general sense all patho- 
logical conditions of the umbilicus, in new-born animals have been the 
object of numerous investigations by Lecoq, Benard, Loiset (1848), 
Bollinger (1874); and more recently by Morot (1884), Uffredizzi (1884), 
Chassaing (1886), etc. 

Omphalo-phlebitis may occur as a primary condition or may appear 
as a complication of omphalitis and of persistence of the urachus. It 
consists essentially in suppurating inflammation of the umbilical vein, 
but is not infrequently accompanied by omj^halitis, arteritis, peritonitis, 
and cystitis. 

Causation. The disease results from infection of the (normal) clot 
and of the wound resulting from severance of the cord. The infection 
may only cause simple phlebitis of the umbilical vein, but if the 
organisms are virulent the phlebitis almost inevitably degenerates into 
suppurative phlebitis. 

Formerly omphalo-phlebitis was thought to be caused by the 
mother licking the foal, by irregular tearing of the cord, by crushing 
and separation of the obliterating clot, etc. The truth is that all these 
causes favour infection of the umbilical wound, which is the primary 
cause, suppurative phlebitis being secondary only. 

When the cord is ruptured both the veins and arteries become 
plugged, and bleeding ceases. This plugging should end in organisation 
of the clot and obliteration of the vessels. If, how- ever, the wound is 



UMBILICAL PHLEBITIS OR OMPHALO-PHLEBITIS. 403 

infected, micro-organisms make their way between the clot and walls, 
and extend along the inner surface of the vein, infecting first the clot 
and then the vein, and thus setting up suppurative phlebitis. 

If suppuration does not continue, recovery may occur spontaneously. 
Infection may be confined to the clot, producing simple phlebitis, but it 
often extends along the umbilical vein to the liver, causes infectious 
hejjatitis and purulent infection or septicsemia. Similar results may be 
produced by infection of the arteries, the organisms making their way 
as far as the bifurcation of the aorta, and thus gaining the general 
circulation. Moussu believes that this is the commonest method by 
which septicaemia is produced in calves. 

Symptoms. In these cases it is usually the general symptoms which 
first attract attention, the local lesion passing unnoticed for a greater 
or less time. 

The animal shows intense fever, due to either suppurative phlebitis, 
infectious hepatitis, or, as often happens, to generalised infection. 
Appetite is lost, diarrhoea is abundant, the respiration and circulation 
are accelerated, and the temperature rises to 104'^ Eahr., or even 
105° Fahr. 

The local symptoms are those usually associated with omphalitis or 
phlebitis. An examination of the umbilical ring reveals an oedematous, 
hot, sensitive swelling, the lower part of which exhibits a chronic, sup- 
purating, fungoid, blackish wound of unhealthy appearance. 

This wound is the seat of one or more sinuses which penetrate the 
vein, arteries, or urachus. If only one sinus exists, it always passes 
upward and forward into the umbilical vein. The utmost precaution 
should be employed in examining the parts. Should it be thought 
desirable to probe the sinus in order to discover its direction, the probe 
must be very cautiously introduced, and only for a short distance, 
because rough handling would tear the tissues and carry infective 
material to deeper seated points. 

Complications. These are numerous and very grave. Long ago 
Lecoq described a disease suggestive of laminitis, which beyond doubt 
was only a form, of purulent infection. At a later date Loiset studied 
a disease following omphalitis, in which interstitial abscesses deve- 
loped in the cord. This also was simply purulent infection. 

More recently complications such as pleurisy, pneumonia, infectious 
endocarditis, diarrhoeic enteritis, and especially suppurative polyarthritis 
of young animals have been referred to omphalo-phlebitis. All these 
complications result from infection. The micro-organisms themselves 
or the toxins they secrete appear to have a particularly injurious action 
on the serous membranes, a fact which throws light on the frequency of 
such complications as pleurisy, peritonitis, endocarditis and arthritis. 

D D 2 



404 DISEASES OF BLOOD-VESSELS. 

Intoxication also plays a certain part, and microbic toxins are 
responsible, at least at first, for the uncontrollable diarrhoea, arthritis 
with sterile exudations, etc. 

Diagnosis. This presents no difficulty. The alarming general symp- 
toms seen at the outset immediately suggest in the case of young animals 
the possibility of disease in the umbilical region. 

Prognosis. The prognosis is grave, it may be said very grave, 
because treatment is difficult to apply, and dangerous complications, 
which almost always prove fatal, may already have been set up. 

One must always distinguish, however, and take into account in 
forming the prognosis, the special characteristics of the phlebitis, and 
weigh carefully the signs of complication. The fistula should be 
cautiously explored, and its depth, etc., noted, while the temperature, 
circulation, respiration, etc., should be carefully studied. 

Treatment. A very important item of treatment consists in regu- 
larly and scrupulously cleansing the region of the umbilicus after the 
cord has separated and until the wound has completely cicatrised. 
The parts are washed with boiled water and dusted with boric acid, 
iodoform, etc. 

A still better plan, and one that almost certainly guards against this 
disease, is to apply an antiseptic dry dressing as soon as the new-born 
animal has become dry. This need only consist of a small sheet of 
antiseptic cotton wool fixed to the umbilicus by four pitch bandages 
or by two pieces of webbing passed over the back. In this way con- 
tamination of the cord and the risk of infection are avoided. 

In cases of fully-developed phlebitis the old generation of practitioners 
used to recommend local dressings with adhesive plasters, astringent 
and vesicant applications, etc. All such methods are useless, because 
they only act on a part of the diseased structures and cannot reach the 
blind ends of the sinuses. The classic treatment of suppurative phlebitis 
also is out of the question. 

All that can be done, therefore, is slightly to open up the sinuses 
and wash them out frequently with antiseptic solutions, such as boiled 
water, sublimate-glycerine, carbolic glycerine, etc., afterwards apply- 
ing antiseptic dressings. These methods, however, are scarcely likely 
to put an end to infectious complications such as suppurative poly- 
arthritis. 

There is no danger in using strong carbolic solution, 3 per cent, 
creolin, 4 per cent, chloride of zinc, sulphate of copper, etc. Should there 
be several sinuses and should one of them extend in a backward direction, 
it is necessary to make certain that no communication exists between 
the urachus and the bladder. For this purpose some boiled water may 
be injected into the sinus. If a communication exist, this water will 



UMBILICAL PHLEBITIS OR OMPHALO-PHLEBITIS. 405 

fill the bladder and distend the urachus. The treatment necessary in 
this case is similar to that of persistence of the urachus. 

It is well in all cases to be guided by the following principle : 
never to resort to treatment unless suppuration has occurred and the 
sinus is blind. To check suppuration a blister may be applied around 
the umbilical region while means are taken to prevent the animal 
licking the parts. 

Chassaing in 1886 suggested a rather original method of operation 
which deserves description. It is founded on the permanent treatment 
of sinuses, and consists in introducing a flexible osier stick, a kind of 
bougie, enveloped in tow and moistened Avith the following mixture : 

Collodion . . . . . . . . . . . . . . 3 parts. 

Sublimate . . . . . . . . . . . . . . 1 part. 

This is introduced for a distance of 3 to 4 inches into the fistula, and 
is fixed to the skin with gutta-percha or pitch. The dressing is renewed 
every five or six days, and healing takes place, it is said, in one, two, 
or at most three weeks. 

It is very likely that if the sinuses were previously cleared and 
simply plugged with antiseptics or treated by introducing pencils of 
salol, nitrate of silver, sulphate of copper, iodoform, etc., at least as 
good results might be obtained. 



CHAPTER V. 
DISEASES OF THE BLOOD. 

SEPTIC/EMIA OF NEW-BORN ANIMALS. 

The above title is given to that exceedingly fatal disease commonly 
known as '' white scour," etc., the mortality in which often rises to 
95 per cent. 

The disease was studied by Poels in Holland in 1889, Dele in 
Belgium in 1891, Perroncito in Italy, Galtier in the centre of France 
in 1891 — 92, and quite recently by Nocard in Ireland in 1901. 

It occurs throughout all the breeding districts of France, and in some 
parts causes enormous losses, the mortality comprising two-thirds or 
even three-fourths of all new-born calves. In certain breeding estab- 
lishments in Normandy all the new-born animals without exception 
die unless special precautions are adopted. 

In foals, septicaemia of the new-born is very rare, because horse- 
breeding establishments are much better cared for, and breeding mares 
are segregated. In byres, on the other hand, the greatest promiscuity 
exists. The disease is equally uncommon in lambs, although it makes 
numerous victims in folds which have once been attacked. It is, how- 
ever, quite common in young pigs. 

Symptoms. The development and course of the disease are in 
certain respects characteristic. 

The disease usually appears within two or three days after birth, and 
only in rare cases after the second week. Calves which at birth ajDpeared 
vigorous and in good health are found dull on the second day ; after the 
second or third meal they suffer from diarrhoea, and from that time 
refuse all nourishment, lie down as though exhausted, and sometimes 
die very rapidly. 

Some even perish in ten to twelve hours without showing diarrhoea ; 
although apparently well at night, they are found dead or dying the next 
morning. This is the peracute form. 

Most frequently the young creatures suffer for two or three days, 
sometimes a week. Appetite is partly preserved ; at first the diar- 
rhoea resembles that due to inability to digest milk, but the faeces soon 



SEPTICxEMIA OF NEW-BORN ANIMALS. 407 

become greyish or blackish and very foetid. The hair of the tail, 
quarters and hocks is soiled and matted, the skin irritable and reddish ; 
the patients lose strength, appear unsteady on their limbs, and develop 
rapid respiration and tumultuous action of the heart. 

They take little food, become weaker by degrees, and die in a con- 
dition of exhaustion. 

Fever, well marked at first, frequently diminishes, and the tempera- 
ture may remain normal for several days, falling to 97° Fahr., or even 
95° Fahr., twenty-four hours before death. 

This is the commonest form of the disease. It lasts three to five 
days, and is always grave. 

Cattle-men recognise the disease chiefly by the diarrhoea and loss of 
appetite. 

Lastly, a third and rarer form occurs during which appetite is main- 
tained in spite of the diarrhoea. The animals remain thin, develop 
poorly, but survive for a month, six weeks or two months. The diarrhoea 
diminishes or disappears, but its disappearance is followed by complica- 
tions such as broncho-pneumonia, pleuro-pneumonia, endocarditis, acute 
arthritis, etc., a fact which led Prof. Galtier to give the disease the name 
of '' septic pleuro-pneumonia in calves." These complications, again, are 
extremely grave, and generally prove 'fatal after a period of varying 
length. They are due to local development of micro-organisms of the 
kind which produce septicaemia, and similar to those described under the 
name of broncho-pneumonia of intestinal origin in sucking calves. 

They differ, however, as regards their cause, from the primary affec- 
tion, and may be due to very varied organisms, the commonest being 
those of suppuration. These organisms, in fact, are alien to the primary 
disease, and obtain entrance from without, very probably by the tracheo- 
bronchial tract. 

In young pigs septicaemia assumes the same forms as in the calf. 
In lambs the chronic form seems more frequent than the peracute 
and the ordinary forms. 

Causation. The septicaemia of calves, and possibly of all new-born 
animals, of whatever species, is produced by a microbe which flourishes 
in the manure and litter of stables, and which Nocard included in the 
group of Pasteurella. It can be found in the blood from the moment the 
first external symptoms appear until the time of death. During the last 
hours, however, the bacterium Coli communis also invades the circulation 
in many instances, and if cultures are not made until some hours after 
death, the colon bacillus and bacteria of putrefaction aie more particu- 
larly discovered. 

The microbe of calf septicaemia can be readily cultivated in jelly or in 
ordinary liquid media. Injected into the veins of experimental animals, 



408 DISEASES OF THE BLOOD. 

it reproduces the clinical symptoms, and causes death more or less 
rapidly, according to the dose injected. 

The virulence of cultures grown in defibrinated calf's blood seems 
more intense, and Moussu has been able to reproduce the clinical form 
of the disease by applying to the umbilical cord of a new-born animal a 
pledget of cotton wool saturated with such a culture, and covering it with 
a dressing. The germs of the disease are spread throughout the byres 
through the medium of faeces. When the umbilical cord has become dry, 
that is, after the third day, the application of virulent cultures to the 
stump no longer causes infection. 

Pathogeny. The pathogeny of this septicaemia of calves and of new- 
born animals is easy to explain. 

At birth the young animals fall on the litter, and the umbilical cord 
becomes contaminated. The infective agent, finding an excellent culture 
medium in the tissues of the cord, at once begins to develop, increases in 
enormous numbers, steadily ascends along the cord, and sets up septi- 
caemia. It grows in the gelatinous Wharton's jelly and in the fibrinous 
plug closing the arteries and umbilical vein, and soon enters the true 
circulation. Septicaemia is then fully established, general disturbance 
sets in, and wdth it the diarrhoea by which it is externally indicated. 

It is important to remember, however, that infection occurs most 
readily through the medium of the cord, and during the first few days 
after birth : it may occasionally be brought about towards the eighth 
or tenth day, when the shrivelled portion of the cord falls ; in this case 
its entrance is effected through the little umbilical wound. 

Lesions. The lesions are sometimes so obscure that the practitioner 
may hesitate to deliver an opinion. 

In acute cases, where death occurs in two or three days, or even in 
ten to twelve hours, post-mortem examination reveals only increased 
vascularity of the serous membranes — the peritoneum, pleura, peri- 
cardium, etc. ; and it may be almost impossible to discover anything 
abnormal in the cord, for although the clots closing the arteries and 
veins are infected, they are neither separated from the walls of the 
vessels nor broken up. 

On the surface of the urachus, at the base of the bladder, and in 
the depths of the peritoneal folds sup^jorting the allantoid arteries 
(sometimes also the hepatic vein), unequivocal signs of local ascending 
infection may, however, almost always be found, together with intense 
injection of the capillaries, little haemorrhagic spots, and commencing 
formation of false membranes, etc. 

The infection extends also by the lymphatic vessels contained in 
these peritoneal folds, and finally attains the sublumbar region. 

When the disease develops less rapidly the peritoneal cavity 



SEPTICiEMIA OF NEW-BORN ANIMALS. 409 

contains a certain quantity of blood-stained serosity, as do the plenrse 
and pericardium, whilst vascular engorgement of the serous mem- 
branes is extremely marked. The intestine shows traces of congestion 
and inflammation throughout its length, and its contents contain the 
specific organism in very large numbers. 

Finally, in the chronic forms, the serous membranes and the intestine 
seem only shghtly attacked, possibly because the lesions have undergone 
retrogressive changes. The striking features are the secondary lesions, 
such as those of pneumonia, broncho-pneumonia, pericarditis, and abscess 
formation in the lung. 

Nocard gives the following description of the lesions found during his 
investigation of ''white scour" of calves in Ireland {Veterinarian, April, 
1902, p. 171 ; see also Prof. Mettam's paper, Veterinarian, June, 1902, 
p. 307) : — " The lesions found on autopsy vary according to whether the 
evolution of the disease has been rapid or slow. One lesion, however, is 
never absent — that of the navel and the navel vessels. In all the calves 
attacked we found a large umbilicus with hardened coats enclosing a clot 
easily broken down, sometimes soft and purulent. In every case, also, 
we observed blood suffusions, often very extensive, along the course of 
the umbilical vessels and of the urachus, invading often the posterior 
third of the bladder. In cases where the evolution had been rapid we 
found the lesions of true haemorrhagic septicaemia. All the viscera were 
congested to excess ; their surface was studded with petechias, ecchy- 
moses, or subserous blood suffusions. The capillary network of the 
peritoneum, pleura, and pericardium appeared strongly injected. This 
lesion was especially marked on the epiploon. The intestine was the 
seat of intense congestion, especially at the level of the ' floating 
colon.' 

" The mucous membrane was thickened, gorged with blood, and 
friable ; the solitary glands, thick and protruding, were sometimes 
transformed into a kind of bloody magma, or they were ulcerated, as in 
anthrax ; the contents of the bowel were mixed with a large quantity of 
blood. The mucous membrane of the fourth stomach was altered nearly 
to the same degree ; it was studded with interstitial haemorrhages, espe- 
cially above the level of the open edge of its folds. The mesenteric 
glands — especially those of the colon — were enormous, gorged with blood, 
reddish, and often haemorrhagic. The mucous membrane of the bladder 
was often covered with petechias, the urine which it contained was clear 
and limpid, but always rich in albumen. [In one sample which was 
analysed, the urine contained more than 4 grammes of albumen to the 
litre.] The lungs were gorged with blood, like the intestines ; sometimes 
they were manifestly oedematous, but generally their tissue was still 
supple, elastic, permeable, and without apparent lesion. 



410 DISEASES OF THE BLOOD. 

" In the subacute forms the lesions are much less marked. The mucous 
membrane of the intestine is less congested ; sometimes oedema of the 
submucous tissue exists. The mucous membrane of the fourth stomach 
is often punctuated with brownish-red patches, traces of the capillary 
haemorrhages which were produced at the onset of the disease. The 
mesenteric glands are swollen, gorged with serum, but not haemor- 
rhagic ; the liver is large and of a yellowish tint ; the spleen is little 
altered; the urine always contains albumen; the lungs are seldom 
quite sound ; they usually contain here and there small diffuse centres 
of catarrhal pneumonia, of nodular bronchial j^neumonia, or simply of 
atelectasis. 

"These lesions are more constant and more dense if the animals 
have resisted the disease for some time ; they then constitute the 
transition stage between the simple collapse at the beginning of the 
disease and the suppurating lesion of lung disease. The joint lesions 
when they exist are very interesting. At the beginning all the peri- 
articular tissues are infilti-ated with a yellowish gelatinous serosity. 
The synovial membrane is covered with vascular aborisations of an 
extreme richness, which extend on to the articular cartilages. The 
synovial capsules are distended by a considerable quantity of thick 
synovia of a deep yellow or brownish tint, holding in suspension flakes 
of fibrous exudate more or less dense and abundant. When the lesion 
is older the synovia is replaced by a thick fibrous exudate, which fills 
sacculations, and extends betwT.en the articular surfaces. In this case 
the lesion appears identical with that of the arthritis seen in pleuro- 
pneumonia of sucking calves." 

Diagnosis. The diagnosis presents no difficulty, for the development 
and acute course of the disease (the majority of patients die within a 
week of birth) leave little room for doubt. • 

This disease is easily distinguished from dysentery in new-born 
animals, which appears at birth, as also from simple diarrhoeic ente- 
ritis; in the latter disease the symptoms are delayed, sometimes occur- 
ring only when the animals are w^eaned ; moreover, the disease is never 
so grave as that now under consideration. 

Should, however, the post-mortem appearances seem indecisive, the 
diagnosis can be based simply on the high mortality. 

Prognosis. The prognosis is extremely grave. About 95 -per cent, 
of the animals attacked die, and among those which survive many show 
thoracic complications, that render them useless. 

Treatment. Treatment of animals already affected is useless, and, 
moreover, too costly. Drugs administered through the digestive ap- 
paratus to a large extent miss their mark, because the digestive symp- 
toms are secondary, primary infection having occurred through the 



SEPTICAEMIA OF NEW-BORN ANIMALS. 



411 



circulation. The administration of purgatives and internal antiseptics 
can, therefore, only prove illusory. 

On the other hand, prophylactic treatment is of the greatest value ; 
all that is necessary is to prevent the umbilical cord from becoming 
infected. 

The great mortality, which causes such severe loss to breeders, is 
simply due to want of proper care of new-born animals. Even in 
carefully kept byres the mortality may be high, for the specific agent 
develops in litter contaminated with faecal matter, by lying on which 
young animals become fatally infected. 

To check or prevent this septicaemia in breeding establishments, it is 
merely necessary to take the same precaution as is taken in dealing with 
young children, i.e., to apply an aseptic or antiseptic dressing to the stump 
of the cord after ligation. As soon as the young animal has been dried 
by the mother or by artificial 
means, a carefully boiled 
ligature is applied to the 
cord at a distance of about 
1 inch from the umbilical 
ring. The portion of the 
cord below the ligature is 
snipped off, the remaining 
part is carefully washed with 
boiled water or boric solu- 
tion, and is surrounded with 
a mass of iodoform wool, kept 
in place by a bandage passed 
over the back. 

The cord will shrivel a 
little less rapidly than it 

would if exposed to the air, but will be protected from all infection. 
The young animal should be separated from the mother to prevent 
her from displacing the dressing by licking the parts. 

In a few days all danger is at an end. This method is very 
simple, and can be carried out even by the breeder and in an in- 
fected byre. Nocard recommends the use of umbilical dressings con- 
taining collodion, and the practitioner can choose whichever method 
he pleases. 

In grave outbreaks involving large establishments, the byres should 
be rigorously disinfected, and it is sometimes well to segregate cows 
about to calve in a special byre, from which the calves are not allowed 
to pass until the umbilicus is cicatrised. 




Fig. 184. 



-Dressing for umbilicus of new- 
born calf. 



412 DISEASES OF THE BLOOD. 



TAKOSIS: A CONTAGIOUS DISEASE OF GOATS.* 

This disease has been seen in Angora goats brought from Texas into 
Pennsylvania, U.S.A. 

Symptoms. The disease presents many of the symptoms usually 
accompanying a parasitic invasion, and is characterised by great emacia- 
tion and weakness, with symptoms of diarrhoea and pneumonia. In the 
early stages of the affection there is usually little to indicate that any- 
thing is seriously amiss with the animal. The first observable symptom 
manifested is the listless and languid appearance of the animal, evidenced 
by its lagging behind the flock, and is usually accompanied by a drooping 
of the ears and a drowsy appearance of the eyes. The pulse is slow and 
feeble, and the temperature is elevated slightly at first, but becomes sub- 
normal a few days before death. The highest temperature observed in 
the natural disease was 104'1°, and the lowest, in a prostrated animal a 
few hours before death, registered 99"7° Fahr. Snuffling of the nose, as 
in a case of coryza, with occasional coughing is sometimes in evidence. 

As the disease advances the animal moves about in a desultory 
manner, with back arched, neck drawn down toward the sternum, and 
with a staggering gait. Eumination is seldom impaired. The appetite, 
while not so vigorous, is still present, though capricious, and the affected 
animal shows plainly that the ravages of the disease are rapidly over- 
coming the restorative elements derived from the food. The fleece is 
usually of good growth, and presents a surprisingly thrifty appearance 
when the condition of the animal is taken into consideration. All the 
exposed mucous membranes appear pale, and the respirations are accele- 
rated and laboured. The goats finally become so weak that they are 
readily knocked down and trampled upon by their fellows. If picked up 
they may move off slowly and eat a little, but within a few hours are 
down again, and in this way linger for several days, shrinking to about 
half their natural weight, and occasionally bleating or groaning, with 
head bent around on the side or drawn down to the sternum. A fluid 
discharge from the bowels of a very offensive odour is usually observed 
in the last few days of life, but this symptom is not constant. 

Course and Susceptibility. This disease may assume a subacute or 
chronic type, usually the latter. The animal dies of inanition in from 
eight days to six or eight weeks. Several owners have reported deaths 
after only two or three days of illness, but the goats doubtless had been 
affected for a longer period, although not noticed on account of their 
mingling in the flock. Many of the animals live for weeks, but gradually 

* Annual Keport, U.S.A. Bureau of Animal Industry, 1902, p. 354 (Mohler and 

Washburn). 



TAKOSIS : A CONTAGIOUS DISEASE OF GOATS. 413 

become weaker and more debilitated, finally dying in a comatose condi- 
tion. In no instance has the natural recovery of an animal after once 
the symptoms of takosis were noticed been observed or heard of. 

The yomiger goats seem to be the most susceptible to the disease, 
although the old animals are by no means immune. 

Pathological Anatomy. As already indicated, the general appearance 
of the carcase simulates that produced by a wasting disease. The visible 
mucous membranes are pale and ansemic, while the fleece, which appears 
somewhat dry and lustreless, furnishes a shroud for the extremely 
emaciated condition, that becomes plainly perceptible on skinning. The 
same ansemic condition of the subcutaneous and muscular tissues is 
observed on eviscerating the carcases. The lungs in most cases are the 
seat of a peculiar diversified inflammation, never of a remarkable extent. 
The external appearance of these organs is at times mottled, caused by 
a few congested areas, several patches of an iron-grey colour similar to 
areas of pneumonia during the process of absorption, and normal tissue. 
On section through the reddened patches, a frothy mucus may exude 
from the bronchioles, and in one case numerous punctiform haemorrhages 
were observed on the sides of the incision. This tissue, while not so 
buoyant as a normal portion would be, nevertheless floats when placed 
in water. 

The heart in all cases is pale and dull, its tissue soft and flabby, 
while inflamed areas, more or less penetrating, are present at times on 
the epicardium about the auricular appendages, and at other times on 
the endocardium, especially that lining the ventricles. These hsemor- 
rhagic patches consist of either pure extravasated blood or blood mixed 
with serum, which gives them a more diffuse appearance and a gela- 
tinous consistence. The pericardium is slightly thickened, and usually 
contains a small increase of fluid tinged with blood. The liver usually 
appears normal, although the gall bladder is frequently distended with 
pale-yellow watery bile. The kidneys are angemic and softened. The 
cortex appears slightly thicker and paler than normal, and contrasts 
strongly with the darker pyramids. The capsule strips off easily from 
the parenchyma of the organ. In one instance several pale areas simu- 
lating anaemic infarcts were observed under the capsule extending into 
the cortex, which probably resulted from the compression of the capillaries 
by the swollen parenchymatous cells. The presence of albumin in the 
urine was detected by the nitric-acid test. The spleen appears atrophied 
and indurated, and on section the fibrous tissue far exceeds the splenic 
pulp. Attachments by fibrous adhesions may fix the spleen to the 
diaphragm or the neighbouring organs. The intestines may contain 
normal faecal matter or semi-fiuid faeces of a disagreeable odour. The 
surface of the mucous membrane is at times covered with a slimy 



414 DISEASES OF THE BLOOD. 

mucus or plastic exudate, and the appearance is that of a chronic catarrh 
associated with necrosis of the mucosa. 

Bacteriology. Examination of cultures and slides showed the presence 
of a micrococcus, usually arranged in the form of a diplococcus, which 
was found in pure cultures from the heart's blood, spleen, kidneys, and 
pericardial fluid, and essentially so in the tubes inoculated from the 
other organs. 

The specific organism of takosis appears in fresh bouillon cultures as 
a spherical or oval micrococcus with a diameter of 0' 8 to 1 ft. In these 
cultures it is single or in chains of tw^o, three, or four elements, but most 
frequently in pairs, as diplococci, with a diameter transverse to the axis 
of the chain greater than the longitudinal diameter. 

Treatment: Prophylaxis. Sudden climatic changes should be 
avoided as far as possible, and when shipments of goats for breeding 
purposes are to be made which necessitate their transportation over 
considerable distances the changes should be made during the months 
of summer or late spring, and not in the fall or winter, when the con- 
trast of temperature will be so much greater. 

Angora goats should be provided with stables that are thoroughly 
dry, erected upon ground that has perfect natural drainage. 

As a third measure of prevention may be mentioned careful feeding. 

The segregation or isolation of all affected animals as soon as they 
evince any symptoms of the disease will be found a most valuable means 
of protection for those that remain unaffected, and a strict quarantine 
over all of the diseased members of the flock should be maintained so 
long as the disease remains upon the premises. 

Medicinal treatment has proved unsatisfactory in many of the cases 
of takosis to which it has been applied. The best results have been 
derived from the administration of calomel in 0.1-gram doses twice daily 
for two days, followed by arsenic, iron, and quinine, as follows : 

Arsenious acid . . . . . . . . 1*40 grams. 

Iron, reduced. . . . . . . . . . . . . . 12*00 ,, 

Quinine sulphate . . . . . . . . . . . . 6.00 ,, 

Mix and make into twenty powders, giving one to each adult goat 
morning and evening at the conclusion of the administration of calomel. 
After an interval of two days this treatment is repeated. In case the 
diarrhoea persists, the sulphate of iron has been substituted for the 
reduced iron, with beneficial effects. 

Conclusions. After preliminary investigation, the following con- 
clusions have been reached : — 

(1.) The disease described as takosis has appeared in many parts of 
America, but particularly in the Northern States, where it has caused 
great loss to many breeders of Angora goats. 



BLOOD POISONING IN SHEEP AND LAMBS. 415 

(2.) It is a progressive, debilitative, contagious disease, characterised 
by great emaciation and weakness, with symptoms of diarrhoea and 
pneumonia, and causes a mortahty of 100 per cent, of those affected 
and from 30 to 85 per cent, of the whole flock, 

(3.) From the carcases of numerous animals that have succumbed a 
new organism. Micrococcus caprirms, has been recovered in purity, and 
is presumably the etiological factor. 

(4.) This micrococcus possesses pathogenic properties for goats, 
chickens, rabbits, guinea pigs, and white mice, but not for sheep, dogs, 
or rats. 

(5.) Medicinal treatment was attempted with varying success, while 
the immunising experiments thus far conducted (although too few to 
permit of any conclusive statement or accurate estimate as to their 
protective value) have shown highly encouraging results. When accom- 
panied with measures of isolation and disinfection, the treatment may 
prove of great assistance in the supjoression and eradication of the 
disease in an infected flock. 

BLOOD POISONING (MALIGNANT CEDEMA) IN SHEEP AND 
LAMBS IN NEW ZEALAND. 

This disease, which occurs during the operations of shearing sheep 
and of castrating and docking lambs, is the cause of considerable loss 
annually to sheep breeders in several districts of New Zealand. In 1893 
J. A. Gilruth, Chief Veterinarian for New Zealand, issued a leaflet 
dealing with the disease and the preventive measures to be adopted. 
Generally the first thing that drawls the owner's attention seriously to 
the condition of his flock is the discovery, in from thirty- six to forty - 
eight hours after docking or shearing, of a few dead sheep lying in 
various parts of the paddocks. Next morning he finds a few more dead, 
and so on for three or four days, when, as a rule, the mortality ceases. 

Symptoms. In the early stages of this disease the animal seems 
listless, disinclined to move about, and, if the sun is shining strongly, 
prefers to lie in the shade. If forced to move, the hind legs are drawn 
forward with a peculiar stiff, dragging motion, as if there were no joints. 
There are slight muscular tremors all over the body, which become 
spasmodic as the disease progresses. If the flock be driven about much, 
the diseased animal soon show^s signs of great fatigue, ultimately dropping 
to the ground thoroughly exhausted. The breathing is fast and j^ainful, 
being maintained more by a series of spasmodic jerks than by any 
regular act. The pulse is quick and weak ; the temperature is very high, 
registering 106° to 108° Fahr., showing acute fever; the eyes close, and 
the whole face is expressive of pain. Gradually the spasms cease and 
coma sets in, resulting in death. The scrotum and surroundinf^ skin 



416 DISEASES OF THE BLOOD. 

right along the floor of the abdomen and between the hind legs become 
swollen and black. This gangrenous tissue, when present before death, 
can be peeled off without pain to the animal. On post-mortem examina- 
tion various conditions are met with. The animals are generally found 
to be among the best of the flock and in fairly good condition. The 
scrotal and perineal regions in lambs (between hind legs and below 
tail) are always, or almost always, gangrenous, this condition extending 
along to the floor of the chest, and sometimes implicating the tail. 
Many of the muscles, generally those of the shoulders, haunches, and 
loins, are dark in colour and infiltrated with a black, watery fluid. The 
intestines are generally healthy, though sometimes the peritoneum is 
inflamed. The spleen and liver are in the usual condition after death, 
due to febrile disturbance. In the chest, either the pleurge (coverings 
of the lungs) or pericardium covering of the heart) are often inflamed, 
with occasionally a fibrinous exudation, causing surfaces to adhere. 

Cause. In Gilruth's report for 1900 he demonstrated the cause of 
blood-poisoning to be a microbe known as the malignant oedema bacillus 
{Vihrion septique of Pasteur). This organism, which is found in many 
dirty yards, swampy soils, etc., on gaining entrance to the system of 
almost any animal by means of a wound, rapidly increases in numbers, 
producing gangrene, or death, of the part affected first, and ultimately 
the death of the animal. 

Curative treatment is practically useless. 

Preventive measures. Destruction of the carcases of animals which 
have succumbed to this disease by efficient burial or by fire. Disinfection 
of surface soil of yards, etc., by quick-lime. Cleansing of floors and walls 
of sheds with strong hot lime wash containing crude carbolic acid in the 
proportion of 1 to 50. Disinfection of flesh cuts made by the shears or 
the docking or castrating knife. Boiling of docking and tailing knives 
before use. Observance of antiseptic applications even when temporary 
yards are employed. Sheep and lambs after operation to be kept in a 
paddock free from swampy patches. 

PIROPLASMOSIS. 

Under the title piroplasmosis is included a group of diseases caused 
by hsemosporidia, and found in animals of the bovine and ovine species. 
These afiections are far from having the same importance in temperate 
as they have in tropical countries ; nevertheless, it is very important to 
be able to recognise them. 

BOVINE PIROPLASMOSIS. 

Bovine piroplasmosis has been described under different names, such 
as haemoglobinsemia, hasmoglobinuria, Texas fever (U.S.A.), tick fever 




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Fig. 189. — Portion of a steer's hide, showing the Texas fever tick {Boophilui 
annulatiis) of the United States. Natural size. (Styles, Ann. Kep. Bur. 
An. Ind. 1900.) 




Fig. 190. — Two female ticks [Hijcdomma ceguptiiim) ovipositing. 
Natural size. (Photograph by J. E. Emerv. Annual Eeport, 
U.S.A. Bureau of Animal Industry, 1900.) 



BOVINE PIROPLASMOSIS. 417 

(Australia), tristeza (Argentine Eepublic), African coast fever, East 
Coast fever, redwater, Ehodesian fever (Cape), and bovine malaria. 

It was first described by Babes in 1888, in animals inhabiting the 
Danube Valley, and was termed by him bacterial hsemoglobinuria of the 
ox. Afterwards it was well described by Smith and Kilborne (in 1889) 
under the title of Texas fever. It was re-discovered in Finland by 
Krogius and Van Hellens in 1894; in Sardinia by San Felice and 
Loi; in Australia in 1895 by Pound; and it has been the object of re- 
markable investigations by Koch in South Africa (1898-1904). 

Nicolle and Adil-Bey (1899) state that it exists in a latent form in 
European Turkey and Asiatic Turkey; and Lignieres (1900), after a 




Fig. 191. — Dorsal view of larva of Boophihis annulatus of North America. Greatly 
enlarged. (Stiles, Ann. Kep., U.S.A. Bur. An. Ind., 1900, p. 388.) 

series of researches in Argentina, suggests the final solution of the 
questions which it raises. 

Symptoms. Babes describes it as an acute febrile disease, clinically 
distinguished by the passage of blood-stained urine. The urine is 
coloured by dissolved hgemoglobin ; red blood corpuscles are not found. 
Smith and Kilborne, and afterwards Stiles, described two forms : an 
acute, rapidly fatal form, in which the Piroplasma bigeminum is found 
in the blood of the general circulation, in the spleen and kidneys ; and 
a chronic form, in which, notwithstanding the absence of clinical signs, 
the parasites may be discovered in the blood under the form of 
diplococci. 

Lignieres describes a grave and a benignant form. The grave form 

D.C. E E 



418 



DISEASES OF THE BLOOD. 



is indicated by dulness, loss of appetite, and considerable fever. In 
twenty-four hours the temperature rises to 104° or 105° Fahr., and 
the pulse to 100 or 120 per minute, while the respiration is greatly 
accelerated. 

The urine is of a light-red or brownish-red colour, resembling 
coffee-grounds, but it contains no blood corpuscles. The animals die 
in from three to eight days with symptoms of asphyxia ; but this 
termination is not inevitable, and recovery may occur spontaneously. 
Improvement is indicated by a fall in temperature, disappearance of 




Fig. 192. — Ventral view of larva of Boopliilus anmilatus of North America. Greatly 
enlarged. (Stiles, Ann. Eep., U.S.A. Bnr. An. Incl., 1900, p. 388.) 

the blood-stained urine, and a return of appetite, together with marked 
thirst. 

Drs. Smith and Kilborne describe the symptoms as follows : — " The 
beast when first observed to be amiss appears to be dull and sluggish, 
with a disinclination to move, and hence it is generally found apart 
from the rest of the herd. The hair stands erect like that of an animal 
on a cold day (a staring coat), the ears hang, and the eyes have a dull 
and lustreless appearance. In some cases the animals cease to feed, 
or ruminate, in others they continue to nibble at the herbage until 
nearly the last, but in a languid, indifferent manner, indicating that 
they have Httle relish for their food, and they fall off very rapidly in 
condition. There is generally a dribbling of saliva from the mouth, 
the muzzle may appear quite moist during the early stages of the 
disease, but it invariably becomes dry and crusty as the disease 



BOVINE PTROPLASMOSIS. 



419 



advances. Later on the animal manifests a strong reluctance to move, 

and when compelled to do so, it walks with a dragging, straddling 

gait, as if weak across the loins. In severe cases, when the sick 

beast is left midisturbed, it will remain almost constantly in one 

place, standing with its head depressed and ears hanging in a drowsy 

semi-comatose condition, looking the very pictm-e of complete nervous 

prostration. Other animals will lie down the greater part of the time 

and scarcely move, and when 

dead the limbs will be found 

in their natural position, and 

the head doubled round on 

the shoulder as if asleep. On 

making a post - mortem ex- 
amination of some of these 

cases the carcase was found 

to be pale and bloodless, as 

if the animal had been bled 

to death. 

" In other acute cases a 

twitching and quivering of 

the muscles will be observed, 

especially of those situated 

in the flank and behind 

the shoulder. The pulse 

and breathing are much 

quickened, and the animal 

will stand and grind its teeth 

and curl up its upper lip, 

indicating great uneasiness 

and pain. The faeces during 

the early stages of the disease 

are very often soft, with a 

tendency to diarrhoea, more 

especially in transport oxen 

on the road, but they invariably become hard as the disease advances ; 

but whether hard or soft, they have generally a brownish tinge, and 

often mixed more or less with blood and mucus. In some severe cases 

which recover, the favourable crisis is often ushered in by a salutary 
|L diarrhoea." 

^L In the benign form the animal for the space of about a week 
^«hows indifference to its surroundings, loses its appetite, wastes, and, 
^Hess frequently, has slight feverish svmptoms, without 




Fig. 193. — Scutum and scutellum of female 
Booijhilus annulatus, showing mouth parts, 
porose areas (_p. a.), and eyes (e). Greatly 
magnified. (Stiles, Ann. Rep., U.S.A. Bur. 
An. Ind., 1900, p. 392.) 



discoloration 
this trifling 
E E 2 



420 



DISEASES OF THE BLOOD. 



disturbance is due to piroplasmosis is furnished by examination of the 
blood, in which the parasites may be found in very small numbers in 
certain blood corpuscles. 

Calves seldom take the disease except in the benign form. 




Fig. 194. — A, red blood corpuscles containing pear-shaped Piroplasma. higeminum 
(the typical form) ; B, red blood corpuscles containing round Piroplasma hige- 
minum. (After Lignieres.) 

Lesions. At first glance the lesions appear to resemble those of 
anthrax, but may be differentiated from them in many details. 

The skin is covered with ticks or shows traces of their punctures. 




Fig. 195. 



The myocardium appears as if boiled, the spleen is invariably 
hypertrophied and two or three times as large as in the normal state. 

The kidneys are violet in colour and congested, and the adipose 
layer surrounding the kidney is infiltrated with a yellowish serosity. 



BOVINE PIROPLASMOSIS, 



421 



The urine maj^ present a variety of tints, derived from haemoglobin. 
The liver is often engorged with blood and the gall bladder always 
distended. 

When convalescence sets in, icterus appears ; but it is a special 
kind of icterus, depending on changes in the haemoglobin — in fact, a 
haemaphseic icterus. Histological examination of the blood furnishes 
the explanation of the disease by revealing the presence of the parasite. 



Fig. 196. — Slow formation of free germs. 1, Pear-shaped organisms with large chro- 
matic element and a flagellum; 2, newly-developed round cell without chromatic 
element ; 3, 4 and 5, formation of the chromatic elements ; 6, the germs about to 
escape ; 7, the germs freed. (After Lignieres.) 

Pathogeny. The parasite is the Piroplasma higeminum, which is 
easily demonstrated by drying the blood, fixing it and staining with 
very weak methylene blue. The blood is light in colour and pale, 
and the serum is tinted by the dissolved haemoglobin. The blood 



3 



#% 



5 



Si»J 



Fig. 197. — Kapid formation of free germs. 1, Newly-developed round parasite without 
distinct germs ; 2, round parasite with two germs ; 3, the germs approaching the 
surface and undergoing development ; 4, the germs beginning to grow outwards 
preparatory to forming new round parasites ; 5, the process previously noted is 
becoming more marked ; the protoplasm of the cell is undergoing degeneration, 
and scarcel}^ stains at all ; 6, round parasites. This completes the cycle. These 
parasites (6) are similar to (1). (After Lignieres.) 



corpuscles diminish in number with extreme rapidity while the para- 
sites are developing, and in twenty-four or forty-eight hours may fall 
from some six millions and a half, the normal number, to one million 
or even to two or three hundred thousand red blood corpuscles per 
cubic millimetre. 

This destruction is due to the action of the piroplasmata, as may 
be shown by staining with a '5 per cent, methylene blue or carbolised 
thionine. These parasites usually assume a simple pyriform shape, 
and two or three may be found in one blood corpuscle. The number 



422 DISEASES OF THE BLOOD. 

of parasites and infected blood corpuscles is generally in direct ratio 
to the intensity of the infection. These parasites are found through- 
out the blood, but principally in that of the spleen, kidneys, and 
mesenteric veins. Tliey are only abundant whilst the temperature is 
rising or at the moment when it reaches its highest point, and they 
often disappear before death or convalescence. 

The pyriform shape is only temporary, and corresponds to the acute 
phase of the disease, but the parasite assumes the round form as soon 
as convalescence sets in. This round form gives birth to one, two or 
three spherical spores, which are set free in the plasma after the 
destruction of the maternal protoplasm, and are able after trans- 
ference to a fresh red blood corpuscle to again assume the pyriform 
shape peculiar to the grave forms of disease. 

The parasite can only be cultivated in defibrinated blood from a 
hsemoglobinuric subject, and the cultures do not always yield more 
than reproductions of the round form, the pear-shaped form only 
being produced w^ith red blood corpuscles in the living animal body. 

Eegarding the method of growth of the piroplasma in the body and 
in cultures, Lignieres believes that the parasite may produce two forms 
of spores differing in their nature. One, the active spore, has little 
resisting power. It soon degenerates outside the animal body, forms 
rapidly at the expense of one of the pear-shaped parasites, and may 
immediately reinfect another red blood corpuscle. The other, called 
the passive spore, is very resistant, and retains its vitality for a long 
time outside the body, being produced at the expense of spherical 
parasites already withdrawn and incapable of producing the disease. 

- The form of piroplasmosis at present under consideration is peculiar 
to the ox, and none of the other domestic animals or experimental 
subjects can be inoculated with it. 

Subcutaneous or intravenous inoculation of the ox with 5 to 10 
cubic centimetres always gives positive results when made with blood 
or active products, such as the pear-shaped parasites or active spores, 
but is ineffectual when the parasites have already begun to retract 
in order to form passive spores. 

Calves seldom contract more than the benign form of the disease, 
and do not die. 

In the grave form following experimental infection the temperature 
begins to rise between the third and sixth day, and corresponds with 
a marked increase in the number of parasites to be found within the 
red blood corpuscles. The urine at first becomes albuminous, then 
hsemoglobinuric, whilst the red blood corpuscles diminish in number 
to a very marked extent, falling from about six or seven millions to 
one million, or even a few hundred thousands, in the course of a few 



BOVINE PIROPLASMOSIS. 423 

days. The temperature, which may previously have risen to ahove 
105° Fahr., suddenly falls, indicating the approach of death. 

If an immediate autopsy is made, the spleen is always found to 
be enlarged, the intestinal mucous membrane reddish in tint or blood- 
stained, and the serous membranes, particularly the endocardium, 
covered with petechiie. 

Few or no parasites can be discovered except in the blood from 
the cardiac muscle and the kidneys. 

The grave form may end in recovery. This end is indicated by 
the temperature remaining normal after defervescence, the appearance 
of hgemaphseic icterus of an obstinate character, and the progressive 
return of appetite. 

The disease is usually transmitted by adult'and larval ticks carrying 
the parasite from infected animals. Lignieres has proved that this 
transmission occurs through the medium of passive spores, which, 
though themselves incapable of producing the disease, become active 
and infective in consequence of the local irritation produced by the 
poisonous saliva of the ticks. 

The pathogeny of Texas fever may be shortly summed up as 
follows : — Animals suffering from the disease carry in their blood a 
protozoan organism called the Piroplasma bigeminiun, analogous to the 
parasite of human malaria ; once introduced into the blood, this 
organism remains there in an active condition throughout the animal's 
life ; it is transferred to susceptible cattle either within or without the 
infected district by the Southern (U.S.) cMle tick Boojjhilus annulatiis ; 
Southern cattle, although carrying the protozoa, are harmless unless 
infested by this particular tick : the mature ticks and their eggs con- 
tain the protozoa, and the mystery of certain grounds over which 
infected animals have passed being first dangerous, then harmless, 
and again dangerous depends on — («) the infestation of the ground 
with mature infected ticks ; (b) the destruction or death of the mature 
ticks ; and (c) the hatching out of new (infected) ticks from the eggs 
laid on the ground by the mature female ticks. 

Dr. Salmon states that in Texas a successful method of protection 
is in practice based on the observations that young cattle do not 
suffer so severely as adults, and that the disease always assumes a 
milder form in winter. Young animals introduced during the wunter 
are inoculated with virulent blood. They contract a mild form of 
disease, and afterwards resist. In this way the losses, which previously 
amounted to 90 per cent, of all freshly introduced stock, have been 
reduced to about 10 per cent. 

A remarkable and very interesting observation (if absolutely reliable) 
deserves to be mentioned, viz., that the ticks develop regularly in the 



424 DISEASES OF THE BLOOD. 

natural prairie, but do not develop in parts artificially sown with grass 
such as lucerne, and that when contaminated or diseased animals are 
transferred to artificial meadows they do not convey the disease to 
other animals already there ; the latter are proof against it. 

Diagnosis. The disease is so typical that it cannot be mistaken for 
anthrax. In anthrax the urine is never hsemoglobinuric and very rarely 
hsematuric, and the faeces are sometimes blood-stained, a symptom never 
present in piroplasmosis. Anthrax can be transmitted to experimental 
animals, but piroplasmosis cannot. 

Prognosis. The prognosis is generally grave. 

Treatment. Van Hellens recommends the use of quinine in large 
doses. He give 5 drachms in one dose, and repeats it for the next two, 
three, or four days. 

Lignieres says that he has never obtained the slightest success 
with quinine, though it is true he has never given higher doses than 
2^ drachms. 

Attempts have been made to confer immunity by injecting animals 
with serum from others which have recovered. Vaccination with the 
blood of patients arrived at the period of convalescence has also been 
tried. The results, however, have not been very satisfactory. 

Lignieres has formulated an efficient method of vaccination, of which 
he has not yet published the full details, but which appeared by reason 
of its simplicity likely to render great service. Nevertheless, his most 
recent reports seem to show that vaccination is not always efficacious, 
and that in the Argentine Eepublic alone several varieties of the disease 
exist, two being caused by allied but different parasites. The vaccine 
used against one variety is powerless against the other. The problem of 
vaccination would therefore appear to be much more complex than in 
the case where one form only occurs in any particular country. 

The immunity arising from attacks of piroplasmosis is in direct ratio 
to the gravity of the disease, and according to Lignieres' views this 
acquired immunity is due to the secretion by the piroplasma of a sub- 
stance which is toxic for the red blood corpuscles. This toxic substance 
provokes, as in other diseases, an organic antitoxic reaction. 

BOVINE PIROPLASMOSIS IN FRANCE. 

Until recent years it did not seem that piroplasmosis occurred in 
France. It had been detected in Algeria, although its existence had not 
been conclusively proved. Mathis claims to have met with it in the 
department of the Loire in 1896 and in the Ain in consequence of 
the importation of Algerian cattle, but its ravages were comparatively 
trifling. 



BOVINE PIROPLASMOSIS. 425 

Having good reason to suspect that certain morbid conditions, known 
as mal de Brou, might be due to piroplasmosis, Lignieres endeavoured 
to verify his theory, and discovered that sometimes, but not often, this 
disease was mistaken in France for anthrax and mal de Brou, Piro- 
plasmosis in France appears less grave than in America, and is rarely 
fatal 

As regards its symptoms, it usually develops suddenly with fever, 
loss of appetite, acceleration of the pulse and respiratory movements, 
suppression of the milk secretion, and the passage of red haemoglobin- 
uric urine. In exceptional cases death may occur in from three to 
five days. 

On post-mortem examination a varying number of ticks {Ixodes 
hexagonus) are found on the skin, the spleen is always increased in 
size, and the kidneys are black and haemorrhagic. 

The disease transmitted by ticks, as in Texas fever, seems due to 
the presence of a round parasite, different from the well-known Piro- 
plasma higeminum. 

The elucidation of this disease, which occurs towards the northern 
frontier of France in the neighbourhood of Maubeuge, calls for further 
investigation. It never appears to be very fatal, and it attacks more 
especially animals imported into the infected region. A method of 
vaccination identical with that used by Lignieres against one of the 
forms of the American disease may perhaps in the future prove avail- 
able against the disease in France. Until then the best treatment 
would appear to consist in free subcutaneous injection of saline solu- 
tion and the administration of evacuants, sulphate of quinine, and 
laxatives. 

OVINE PIROPLASMOSIS. 

Causation. The existence in France of this disease has not yet been 
clearly established, for in the only communication on the subject (by 
Leblanc in 1899) the writer seems to have confused the toxic haemo- 
globinuria produced by feeding on decomposed beet pulp with the 
parasitic haemogiobinuria due to piroplasmosis. 

In Italy ovine piroplasmosis was described by Bonomo in 1896 under 
the title of parasitic icteric haematuria of sheep. It is said to be due to 
a parasite of the red blood corpuscles {Amoeba sporidium polyphaguvi), 
the said parasite being of oval form, very refractile, always occupying 
an outer position near the free margin of the corpuscle, and sometimes 
floating freely in the plasma. 

According to Babes, who described it under the name of garceac du 
mouton, the same disease appears to occur in the islands and low parts 
of the Danube valley. 



426 DISEASES OF THE BLOOD. 

Symptoms. The development of this parasite produces in the 
patient loss of appetite and high fever, accompanied by the passage 
of dark coloured hsemoglobinuric urine. Icterus is frequently present. 
The animals rapidly become exhausted, collapse and die. 

On post-mortem examination carried out immediately after death 
the spleen is found to be large, the pulp being like wine lees. The 
liver is soft and yellowish ; the kidneys are soft and black. 

The disease is said not to be transmissible by direct trans- 
fusion (?). 

It would appear that this disease has also been seen in Turkey by 
Nicolle and Laveran, near Constantinople, in 1899. The parasites {Piro- 
plasma oris) are round or slightly elongated and occur near the peri- 
phery of the red blood corpuscles. It is to be hoped in the interest of 
breeders in localities where this disease rages that Lignieres' method of 
vaccination against bovine piroplasmosis may prove reliable and equally 
applicable in the case of sheep. 

DISEASES PRODUCED BY TRYPANOSOMATA.* 

In 1904 Professor Koch delivered an address, from which the following 
is a summary, to the Berlin Medical Society regarding his experiences 
and observations on diseases produced by trypanosomata in Africa : — 

A wide field of study has recently been opened by the discovery of 
various pathological protozoa. Three discoveries especially have directed 
attention to these special disease organisms — 

(1.) Laveran's discoveries regarding malaria. Boss has shown that 
the malaria parasites are carried by mosquitoes {Anopheles claviger). 

(2.) The discovery of the protozoa of Texas fever by Smith. In this 
case ticks {Rhijnceplialas {hoophilm) annulatus) convey the disease. 

(3.) The discovery of the trypanosoma of the tsetse disease, which is 
conveyed by a stinging fly {Glossina morsitans). 

These discoveries were followed by numerous others indicating pro- 
tozoa as causes of disease. 

The trypanosomata are morphologically distinguished by the existence 
of a flagellum. When fresh blood is examined it is scarcely possible to 
overlook the protozoa in the preparation, for attention is at once attracted 
by the energetic way in which the red blood corpuscles are continually 
being displaced. The 2)eculiar form of the protozoa, however, can only 
be detected in stained preparations. Bomanowsky's staining method is 

* An interesting article and a series of figures on the "Evolution of the 
Trypanosojna Evansi " were pnbhshed in the Jour, of Comjp. Path, and Therajp. 
for September, 1904, p. 210. The same number also contained articles on several 
piroplasmic diseases. 



DISEASES PRODUCED BY TRYPANOSOMATA. 427 

probably the best. Trypanosomata stained by this method show a fish- 
shaped body, the front end of which carries a flagellum. The body of 
the trypanosoma is coloured blue. At the anterior end may be seen a 
red- stained nucleus ; at the opposite end a much smaller red spot, which 
has been termed the nucleolus, but is more properly described as the 
centrosome. From the centrosome a red thread extends along the outer 
margin of the body as far as the front extremity, where it becomes 
continuous with the flagellum. 

The trypanosomata increase by longitudinal fission. The centrosome 
and then the nucleus divide, and finally a second flagellum is formed. 
Sometimes the young trypanosomata remain connected, producing the 
so-called ''rosettes." 

The disturbance produced by trypanosomata seldom becomes acute, 
but often continues for years. The only sign of disease consists in ill- 
defined fever with long intermissions. The destruction of the red blood 
corpuscles causes anaemia, the animals or men become weak and waste 
away, oedema and sometimes erythema occur at varying points in the 
body, and occasionally the lymphatic glands become swollen. 

The classical land of the tsetse disease is in the neighbourhood of the 
Zambesi. There it was seen and very well described by Livingstone ; 
but, unfortunately, further investigations have shown that tsetse disease 
extends over the whole of Africa. 

Whilst the trypanosomata of rats can only be conveyed to the one 
species, those of tsetse disease thrive in all mammals, particularly in the 
horse, mule, ox, dog, rat, and mouse. 

The tsetse organism has been shown to kill both horses and mules, 
but to be less dangerous for oxen. A certain relative immunity exists in 
some races. As regards the ass, observers are not agreed ; Koch failed 
to infect it. Sheep and goats are also but slightly susceptible. The 
conveyance of trypanosomata from the blood to uninfected animals 
occurs through the medium of a stinging fly (the Glossina morsitans). 

Surra is endemic in the Philippines, Java, and the island of Mauritius. 
Koch regards the trypanosomata of surra as strictly analogous with the 
parasites of tsetse disease. Horses (and, in India, elephants) especially 
suffer from surra. Although the Glossina morsitans does not occur in 
India, other stinging flies replace it and convey the disease. 

Another variety of trypanosomiasis is mal cle caderas, seen in 
South America, particularly in Argentina and Brazil. It affects horses. 
According to Koch, the parasites of mal cle caderas exactly resemble 
the tsetse and surra parasites. Other observers, however, declare that 
the Dial de caderas parasites are distinguished from those before men- 
tioned by their particularly small centrosome. Mal de caderas affects 
not only horses, but all the other animals which suffer from tsetse. ■ 



428 DISEASES OF THE BLOOD. 

Another variety of trypanosoma, the trypanosoma Theileri, is espe- 
cially striking on account of its size. It is only found in oxen, and 
exhibits a very slight degree of virulence. 

Koch divides trypanosomata into two great groups. 

The grouping is based on three important peculiarities : firstly, the 
morphology of the parasite ; secondly, its virulence ; and, thirdly, its 
relation to the host. 

The first group only exists in one species of animal. They have 
become so completely accustomed to this method of life that they can- 
not exist under other circumstances. Their virulence is slight but con- 
stant. This group comprises the trypanosoma of rats and the try- 
panosoma Theileri. 

. The second group (to which all other trypanosomata belong) shows 
great variation in virulence and in form. These trypanosomata are not 
peculiar to any one species, but may affect dogs, rats, horses, etc. Their 
morphological peculiarities also vary according to the animals in which 
they are found. Thus, the tsetse parasites when cultivated in the bodies 
of dogs and rats become much smaller than usual, and the centrosome 
appears near the end ; when cultivated in horses the end appears 
pointed, and the centrosome lies near the centre ; in the pig the para- 
sites lose their peculiar short flagellum. Their virulence also varies 
within wide limits. 

It has been found possible, as in the case of bacteria, to modify the 
virulence of trypanosomata by successive passages through different 
animals. By inoculating dogs with comparatively innocuous trypano- 
somata and conveying the disease from dog to dog the virulence is 
markedly increased. On the other hand, parasites which prove very 
virulent for oxen become much less active for these animals after pas- 
sages through rats and dogs. This apparently trifling discovery laid the 
foundation for protective inoculation experiments. Parasites of the 
second group can also exist in the bodies of almost all mammals. 

Koch is of opinion that the parasites of surra in India and of tsetse 
disease in Africa are absolutely identical. Laveran, on the other hand, 
states that he has protected animals against tsetse, and that they have 
nevertheless suffered from surra. 

That this in no way dis]3roves the identity of the two parasites is 
shown by other experiments. 

Koch, whilst in Dar-es- Salaam, made some interesting experiments 
for the purpose of discovering a method of protective inoculation. He 
had found that the virulence of the ox parasites could be modified. He 
therefore inoculated oxen first with these weakened parasites and after- 
wards with others of high virulence. All the control animals died while 
those treated as above remained alive. 



LOUPING-ILL. 429 

Veterinary Surgeon Schmidt kept these animals under observation, 
and reinoculated them from time to time with highly virulent material, 
notwithstanding which they were still perfectly well six years after the 
first inoculation. 

In practising this method, however, the trypanosomata used for the 
first inoculation must not be unduly weakened. The method would have 
appeared fully successful were it not for the fact that the protected and 
apparently quite vigorous animals still suffered from the presence of 
parasites in the blood. To extend its use, therefore, meant that one 
would not suppress, but would spread the disease. The effect would 
be to produce herds harbouring the parasite, which herds, though 
exhibiting no signs of illness, would nevertheless in a sense be propa- 
gating the active cause. Further observation has also shown that the 
protection so conferred is only relative. Dogs can always be infected 
with the blood of such animals. It has long been known in Africa that 
antelopes and buffaloes harbour trypanosomata in their blood without 
showing external signs of disease. 

Another method of protection must therefore be sought, such as 
destroying the various stinging flies ; but this offers little hope of 
success. Koch admits that he sees no method of dealing with them. 
The other method is directed against the parasite, and here he seems 
more hopeful. The disease can be rooted out by killing all diseased 
animals sus]3ected of disease. The line of procedure is indicated by the 
experience gained in Mauritius and Java. When surra broke out in 
Mauritius almost all the oxen died in two years. In Java the nature of 
the disease was early recognised, and all suspected animals were at once 
slaughtered or isolated until slaughtered ; in this way the disease was 
soon stamped out. 

LOUPINGJLL. 

The close analogy between the -convulsive form of the disease 
described as "trembling" (which disease is well known in France) and 
the condition known in Britain as louping-ill lead us to give here a short 
account of the latter condition. For a great part of what follows we are 
indebted to articles by Meek and Greig Smith, published in the Veteri- 
narian, Vol. LXIX, Nos. 820 and 840. 

Nature and Symptoms of the disease. The disease known usually 
as louping-ill or trembling has long been of annual and sometimes of 
biennial recurrence in certain parts of Great Britain. In these places 
sheep farmers look for the appearance about the middle of April, to its 
continuation during May, and to its gradual disappearance early in June. 
Lambs are most liable, but sheep are also quite susceptible to the disease, 
and in both the symptoms are the same. The disease under consideration 



4.30 DISEASES OF THE BLOOD. 

is rendered quite distinct by certain well-knoAvn symptoms. Though 
these have been described in various ways, the disease can be recognised 
by the more or less complete paralysis of the body and limbs. Symptoms 
may succeed one another very rapidly, or may be spread over some length 
of time. The animal at first loses control over the muscles, which are 
seen to twitch convulsively. It may fall down and struggle on the 
ground, sometimes jumping up again, often to some height. Between 
the fits it is often seen to stand trembling. These symptoms are fre- 
quently accompanied by frothing at the mouth. Some such appearances 
are the usual onset to the disease, and are followed by a paralysis which 
usually affects the hind limbs, but may also include more or less of 
the body and the head and neck. The fore-limbs are often similarly 
paralysed. The affected limb or limbs become cold to the touch. The 
paralysis necessarily brings the animal to the ground, though it may be 
able to crawl about by the aid of the unaffected legs. When the head 
and neck are affected the former is usually drawn to one side, and the 
eyes often become oblique. Excitement is greatly increased when the 
animal is disturbed. The symptoms, then, in a few words are more or 
less complete paralysis, preceded as a rule by fits and trembling. 

The small number which recover present '' a wry neck, stiff joint, 
high back, or other deformity." During recovery swellings occur at the 
joints ; these may be pierced with good results, giving a large discharge 
of pus. According to Fair, in the Veterinarian, Vol. YIII., ''these abscesses 
usually appear in the neighbourhood of the joints, but sometimes above 
the arms, the brisket, or any neighbouring part of the body." 

While the disease is characteristically a sheep ailment, other animals 
are also liable. Swine fed with the carcases or blood of sheep which 
have succumbed to louping-ill die with every characteristic of the disease 
in a short time. If the carcase has been boiled this does not occur. 
Swine will also frequently take the malady if allowed access to the grass 
of affected fields. Cattle are said to take the disease, and in the North 
Tyne district it is said that if a cow takes louping-ill, the milk will give 
the illness to a calf or lamb. One or two cases of horses being attacked 
are also reported. 

Eegarding the infectious character of louping-ill, the following is very 
well known. Sheep bred on diseased places are not nearly so liable to 
the disease as sheep which have been introduced from unaffected places. 
Louping-ill may be introduced into a new place, but in such cases, 
unless the importation from affected farms be continued, the malady 
may disappear. 

Distribution of the disease. In Great Britain it is confined to the 
North Tyne district of Northumberland and to the contiguous border 
counties of Scotland, extending into Kirkcudbrightshire and certain 



LOUPING-ILL. 



431 



valleys of Dumfriesshire. It is rare in Berwickshire, common in 
the north and west of Eoxbnrghshire and the similar hilly districts 
of Selkirkshire and Peeblesshire. It occurs in AjTshire, to a slight 
extent in Lanarkshire, and is found in the western parts and islands of 
Argyleshire and Inverness- shire. 

Not only is the disease very circumscribed in its distribution as a 
whole, but locally in the places mentioned infected and non-infected 
spots are pointed out. These may be quite contiguous. The flocks in 
the North Tyne district feed up and down the hills in limited " cuts," 
and it is one of the features of the illness that certain " cuts " are very 
liable to it, while others, even on the same farm, are just as free. In 
many cases the nature of the pasture is such as to suggest to an ex- 
perienced man the probability of its being subject to the disease. A dry 
and foggy pasture seems best suited for harbouring the cause of the 
malady. These infected places have remained wonderfully constant, but 




Fig. 198. — Larva of the 

grass tick. 
Length, ^V^h of 1 mch. 




Fig. 199. — Pupa of the grass tick 
Length, ^^gth of 1 inch. 



a peculiar feature about them is that some may be very bad for louping- 
ill one year, and others bad another year. Of two adjoining farms, one 
may be badly attacked and the other mildly, while in the following year 
the conditions may be reversed. Districts may present the same pecu- 
liarities. Thus, though the disease is essentially endemic, it is not abso- 
lutely constant in its recurrence. There seem to be certain circumstances 
capable of favouring or retarding it. 

Lesions. The chief lesions are localised in the membranes of the 
brain and spinal cord, which are congested or inflamed, and contain an 
increased amount of cerebro- spinal fluid or a jelly-like, sometimes blood- 
stained exudation. Softening and hardening of the spinal cord have both 
been observed. Inflammation of the pleura and pericardium, with fluid 
or jelly-like exudation, are common ; lobar congestion of the lungs, endo- 
carditis, gastritis, and enteritis have all been described ; some observers 
have mentioned congestion of the kidneys and liver and swelling of 
the spleen. Lesions of the nerve-centres are the most constant and 
reliable. 



432 



DISEASES OF THE BLOOD. 



Etiology. Depressing and weakening influences of all kinds have 
been blamed for producing the disease, but the general consensus of 
opinion points in the direction of infection with micro-organisms carried 
and introduced into the sheep's system by the common sheep tick or 
'' grass tick " {Ixodes reduvius). The following remarks on, and illus- 
trations of, this parasite are from an article by Mr. Wheeler, of Alnwick 
{Veterinarian, Vol. LXXIII., No. 867, p. 141). 

Life History of the Grass Tick. Sheep ticks (which must not be 
confused with the sheep-ked, or keb, a wingless six-legged fly, universal 
on sheep everywhere) are allied to the spiders. They pass through four 
stages of existence : the egg — the six-legged larva — the eight-legged 
pupa — and, finally, the eight-legged adult male or female. 

In each of the three stages of larva, pupa, and adult female, all 




Fig. 200. — Adult male of the grass 
tick. Length, ^th of 1 mch. 




Fig. 201.— Adult female. Length, ^th of 1 mch. 



species of ticks attack some '' host " or animal, either beast, bird, or 
reptile, to which they attach themselves by the " rostrum " or beak, and 
become greatly distended by suction of the host's blood. When replete 
they fall to the ground — if a larva or pupa, in order to undergo its 
metamorphosis to the next stage of its existence, and afterwards seek a 
fresh host ; if an adult female, to lay its eggs amongst herbage. The 
adult male is not capable of distension by suction, though it equally 
attaches itself to a host. 

After undergoing metamorphoses, grass ticks, with the exception of 
males, are light in colour, soft and lethargic, and remain concealed for 
some time while recovering strength before seeking a fresh host. 

Professor Neumann alludes to the fact that a fresh host is sought by 
ticks three several times during their existence. 



LOUPING-ILL. 



433 



The Larva. When first hatched out from the eggs, which are sup- 
posed to be laid at the roots of coarse herbage, the young ticks are 
white and soft, but soon gain strength. Provided the weather is favour- 
able, they climb up the stems, and, holding by their two posterior pairs 
of legs, await the passing of a host, employing their two front legs as 
insects use their antennae. 

In this, as in other "free living " stages of their existence, the young 
larvae show great activity, attaching themselves and clinging tenaciously 
to any moving object. They appear to be more numerous on the rank 
rushes growing in damp, undrained places. 

On finding a host, larvae attach themselves by the rostrum, and remain 
there for about two days, by which time they are distended, black and 
globular. At this time they are easily detached 
from the host, and have lost their activity and 
clinging habits. 

The Pupa. The possession of eight legs dis- 
tinguishes the pupa easily from the larva. The 
extra pair are placed behind the others. After 
the metamorphosis, the pupa takes up its posi- 
tion on the stalks of herbage, just as the larva 
had done, for another chance of attachment to 
a host. But whereas adult grass ticks seem to 
confine themselves mostly to sheep, cattle, and 
deer, the larvae and pupae attach themselves 
very readily to various hosts, such as horses, 
dogs, and even human beings. After about 
four days the pupa is again replete with blood, 
black and opaque, and again drops to the 
ground to undergo its second and final change. 

Adults. On reaching the adult age, both males and females again 
wait on herbage for a passing host. At this time, as well as after dis- 
tension of the female on the host, an action which appears to be sexual 
intercourse freely takes place, even in confinement. On the host the 
females gradually distend (Fig. 202), and in the course of so doing vary 
much in colour and appearance. When fully replete, the female Ixodes 
reduvius becomes globular and black. One taken in this condition on 
April 15th commenced to lay on May 12th, and a few others taken at 
the same time commenced shortly afterwards. 

Grass ticks never remain on the host to undergo metamorphosis or to 
lay eggs. They must therefore during their cycle of existence contrive 
to find a fresh host no fewer than three times. 

In an article published in the Transactions of the Highland and 
Ag. Soc. for 1902 Mr. Wheeler draws attention to the close points of 

D.C. F F 




Fig. 202.— Partially dis- 
tended female. The 
dotted white line repre- 
sents the size of the 
tick before distension. 



434 



DISEASES OF THE BLOOD. 



resemblance between louping-ill, Texas fever, tsetse fly disease, surra, 
heart-water, yellow fever, and malaria. 

In the article previously referred to he summarises his conclusions 
as follows : — 

One species only of tick, Ixodes recluvius, commonly known as the 
grass tick, has been found to carry the louping-ill bacillus to the sheep. 
It is easily recognised by the red body of the young females, the legs, 
shield, etc., being dark brown. 

It lays its eggs, and undergoes its metamorphoses, in coarse 
herbage, and after each change seeks a fresh ''host" on which to 
distend itself to a large size by suction of blood. 

In all stages grass ticks abstain from all food except when on a host, 





Fig. 203. — Female, under size. 



Fig. 204. — Headless female. 



and they are endowed with extraordinary powers of fasting until a host 
is found. 

Ticks soon die of drought where there is no good harbourage among 
rank vegetation. 

Judging from analogy, it is probable — 

That the bacillus can only be obtained from a diseased sheep, and 
inserted by the tick into another sheep. 

That ticks convey the bacillus through their eggs to their offspring, 
as well as retain it through their metamorphoses. 

That there is no danger in removing sheep from foul ground to 
cultivated lowlands, but that the disease is easily imported from one 
hill farm to another. 

Strong and fat animals are nearly as susceptible to attack as weakly 
ones. 

If the land is once free of disease, it can only be re-imported by 
diseased sheep, or ticks taken from them. 



BRAXY. 435 



SUGGESTED MEASURES FOR PREVENTION. 

Burning and cutting of long grasses, bracken, rushes, etc. 

Salt and sulphur given to the sheep. 

Inoculation. 

Kemoval of all diseased sheep to a separate inclosure, where hand- 
picking and dip]3ing are carefully attended to, the pasture is kept short, 
and damp places are drained. The sheep to be confined to this in- 
closure so long as the tick season lasts. 

Immediate slaughter and burial of all affected sheep. 

BRAXY. 

[The following is a very condensed account of a paper published by 
C. 0. Jensen on the above disease. It first appeared in English in the 
Veterinarian, Vol. LXIX., No. 825, p. 621, along with the original 
illustrations.] 

The name Braxy is applied to a disease in some respects resem- 
bling anthrax, which appears as an epizootic, and is best known in 
Iceland, the Faroe Islands, and parts of Norway, though it also occurs in 
Scotland and Cornwall. Krabbe describes the disease as infectious, very 
acute in its course, and as proving fatal within a few hours of the 
appearance of certain characteristic swellings about the posterior parts 
of the body. Post-mortem reveals extensive dark purplish staining of 
the abomasum and distension of the digestive canal with gas, while de- 
composition of the cadaver occurs with excessive rapidity, the liver and 
kidneys undergoing softening, the skin assuming a bluish tint, the wool 
becoming loose, and the entire carcase giving off a most offensive stench. 
Krabbe states that the disease was regarded as a form of anthrax — a 
view, however, in which he does not coincide. Somewhat later Messrs. 
J. Sigurosson, S, Jonsson, and Einarsson, all natives of Iceland, and 
the Norwegian State Veterinary Surgeon, Ivar Nielsen, carefully de- 
scribed the disease, throwing considerable light both on the conditions 
in which it aj)pears and on its etiology. 

According to them, braxy is an acute, or even exceedingly acute, 
infectious disorder, which begins as a hsemorrhagic inflammation of the 
mucous membrane of the abomasum, is accompanied by excessive de- 
velopment of gas in the digestive canal, especially in the stomachs, and 
proves fatal in some cases by a kind of general infection, in others by a 
specific intoxication, or by dyspnoea due to tympanites. 

Braxy commits its chief ravages during the winter months : appearing 
first in autumn, the cases increase as winter aj)proaches, to diminish again 
in spring ; in summer they are exceedingly rare. This fact explains why 

F F 2 



436 DISEASES OF THE BLOOD. 

the disease was so long regarded as due to climatic influences. Even at 
the present day, when it is known to be due to a specific organism, the 
action of temperature, etc., must still be regarded as probably playing an 
important part in infection. The disease is said not to occur in mild 
wreath er ; but whether or not this be true, every one is agreed that it is 
principally seen during frost, especially when frost is unaccompanied by 
snow. 

From experience gained both in Iceland and Norway, the disease 
appears to be often localised in certain districts and fields — a fact largely 
accounted for when we learn that up to the present little or no attempt 
has been made to prevent the spread of infection from the dead 
bodies. 

Braxy chiefly attacks young animals, and is rare in those over three 
years of age. Hjaltelin estimates the number of deaths in a single 
district during the years 1849 — 1854 at approximately 6,000, made up 
as follows : — 

Yearling lambs 2,440 

Two-year sheep . . . . . . . . . . . . . . 2,460 

Three-year sheep . . . . . . . . . . . . . . 1,020 

Animals older than three years . . . . . . . . . . 80 

The younger animals suffer most, and in Norway Nielsen directs 
attention to the heavy fatalities amongst lambs. 

Symptoms. The sheep suddenly appears ill, is dull, lies about, and 
cannot be induced to rise ; all movement seems to give pain, and from 
time to time the animal groans ; the posterior parts of the body become 
swollen, and a little froth often escapes from the mouth. The pulse 
varies between thirty and thirty-five per minute, and is often imperceptible 
in the extremities ; the temperature may rise to 105° or even 108° Fahr. 
This condition may last some hours, and always ends with the animal's 
death; sheep, which overnight had shown no signs of illness, are often 
found dead in the morning. The incubation period is from forty-eight to 
sixty hours, but ordinary cases seldom live longer than from five to eight 
hours after the symptoms declare themselves. 

The striking post-mortem appearances, especially the hsemorrhagic 
inflammation of the abomasum, were early the subject of remark. This 
appearance is very characteristic. 

If the animals are slaughtered, the most important change is found to 
be a purplish, dark, somewhat swollen patch in the abomasum ; during 
the course of the disease this increases in size, and if the animal should 
be allow^ed to die of braxy the entire abomasum shows hsemorrhagic or 
sero-hsemorrhagic infiltration ; the abomasum and the first part of the 
small intestine usually contain no food, but may often show a certain 
amount of bloody fluid. This haemorrhagic inflammation may extend in 



BRAXY. 



437 



a forward direction, implicating the other stomachs, or backward, in- 
vading the small or both small and large intestines. The other parts of 
the intestinal canal are congested. The pleural and peritoneal cavities 
contain a little serous fluid. The blood is dark in colour, but may be 
clotted ; the spleen is at times somewhat swollen, at others normal. The 
liver is usually light-coloured, soft, and degenerated ; occasionally this 
degenerative process is extremely marked, but due allow-ance should 
always be made for post-mortem change. The kidneys may appear 
degenerated ; in many cases they are enlarged and soft, or almost fluid 




Fig. 205. — The shaded areas of the above map indicate the distribution of braxy. 



in consistence. The carcase decomposes very rapidly; within a short 
time of death the belly is distended with gas, the rectum protrudes at 
the anus; the skin assumes a bluish colour in places, and the wool falls 
out ; sometimes the skin bursts, revealing the presence in the sub- 
cutaneous tissue of a sero-haemorrhagic fluid. 

Braxy is, then, a primary violent haemorrhagic inflammation of the 
abomasum, with or without secondary general infection. 

From careful study it seems quite certain that the Scottish " braxy ' 
is identical wdth the Norwegian and Icelan(]ic " bradsot " ; it appears at 



438 DISEASES OF THE BLOOD. 

the same season, and is intimately connected with cHmatic influences ; it 
runs its course so rapidly that animals left healthy at night are found 
dead in the morning ; and the pathological anatomy of braxy is the same 
as that of " bradsot." 

To Ivar Nielsen, of Bergen, must be ascribed the honour of elucidating 
the etiology of braxy. During the course of investigations, published 
in 1888, be found, partly in the local lesions of the intestinal track, partly 
in the capillaries of the internal organs, a special bacillus, easy to distin- 
guish from that of anthrax, of which he gives the following description : 

" The bacilli {B. gastromycocis-ovis) are oval, of a length varying 
from 2 to 6 micromillimetres, and a thickness of one micromillimetre. 
Tbey are often in pairs, arranged in a straight line or meeting at an 
angle ; in the former case, and especially if deeply stained, the pair may 
present the appearance of a single bacillus. Occasionally they form long 
chains. Near the centre of the bacillus, but not always centrally placed, 
may often be found a zone measuring more than half the total length of 
the bacillus, and exhibiting little or no colouration. It appears as though 
the stained portions gradually contracted, finally forming two deeply 
coloured masses at the poles of the lemon-shaped bacillus, which then 
somewhat resembles the bacillus of rabbit septicaemia, except that the 
unstained part of the braxy bacillus is larger and more rounded, appear- 
ing to be bulged out laterally. In dry preparations the bacillus is easily 
recognised on account of the highly retractile character of the colourless 
portion ; but in sections careful search is often required, especially if the 
section be somewhat thick. Whether the colourless portion represents a 
spore cannot at present be said, though such appears probable. The 
bacillus is always found in the mucous membrane of the abomasum, and 
especially in the submucous and subserous connective tissue. In the 
other organs the bacillus may be present in considerable numbers, or, on 
the other hand, may be impossible to detect." 

The same bacillus has been found in the tissues of affected sheep both 
in Norway and in Iceland ; the bacillus, when subcutaneously injected, 
produces a violent hsemorrhagic inflammation of the same character as 
one finds in the abomasum in cases of spontaneous braxy, and the local 
changes at the point of inoculation may, just as in spontaneous braxy, 
be accompanied by a general infection with degeneration of different 
organs, and with softening of the kidney substance. 

The bacillus of braxy is anaerobic. In cultures it develops consider- 
able quantities of gas, just as it does when inoculated into the tissues. 
It is closely related to the bacillus of symptomatic anthrax, which it some- 
what resembles in general appearance, and of which it reminds one by 
its ability to produce hsemorrhagic inflammation in the muscular tissues. 
It is distinguished from the last named, however, by being pathogenic to 



BILHARZIOSIS IN CATTLE AND SHEEP. 439 

swine, mice, pigeons, and poultry, which are not killed by the bacillus of 
symptomatic anthrax. 

The bacilli of braxy, malignant oedema, symptomatic anthrax, together 
with Ivar Nielsen's shortly described bacillus of whale's septicaemia, and 
Thoma's bacillus of malignant emphysema (found in extensive sub- 
cutaneous inflammation and emphysema in man), and certain others less 
well known, form a group of closely allied bacilli resembling one another 
in form, in being anaerobic, and in producing a sero-hgemorrhagic inflam- 
mation and emphysema, but differing in the manner of producing their 

effects. 

Experience and analogy both seem to indicate that young animals 
occasionally suffer from mild attacks of braxy from which they recover. 
Such animals afterwards exhibit a well-marked immunity against the 
disease. 

Ivar Nielsen attempted to vaccinate against braxy by a method 
resembling that used in black-quarter. He dried the diseased kidney 
tissue, and injected subcutaneously small quantities of the material thus 
obtained suspended in water. A slight local inflammation followed, which 
appeared to protect against later " spontaneous " infection » He has used 
this method in his own district, and states that it is also practised to some 
extent in Iceland. As far as one can judge — and of course a just opinion 
is very difficult to form — these inoculations appear of value. 

The result of experiment, considered m conjunction with the good 
results of inoculation for black-quarter, would seem to indicate that 
Nielsen's method of vaccination against braxy may yet prove of the 
greatest possible value, although the method will doubtless require 
modification in its details. 

These modifications Jensen enumerates at some length. 

(Mr. Dollar has been informed that Professor Hamilton and Dr. McCall 
have been engaged in an investigation regarding the possibility of con- 
ferring immunity against braxy, and that a Government report will be 
issued on the subject. Up to the present time however — April, 1905 — he 
has not been able to obtain this report or any advance proof sheets of it.) 

BILHARZIOSIS IN CATTLE AND SHEER 

This disease is caused by the bavine blood fluke {Schistosojna bovis 
of cattle and sheep. Synonyms : Bilharzia bovis ; Billiarzia crassa ; 
Gyncecophorus crassus ; GyrKecophoriis bovis; Bilharzia hcematobia crassa ; 
Schistosomum bovis. 

Geographical Distribution. Egypt, Italy, Sicily, India (?). 

This parasite was discovered by Sonsino (1876) in Egypt in the 
portal veins of the ox, and. later he found it in sheep, while Grassi 



440 



DISEASES OF THE BLOOD. 



and Kovelli afterwards found it in about 75 per cent, of the sheep 
slaughtered at Catania, Sicily. 

Source of Infection. Clinical observation and analogy point to 
unfiltered drinking water as the source of infection. 

Position of the Parasite. The worms are found in the veins 
of the abdomen, the vena porta, vena linealis, vena renalis, and the 
venous plexus of the bladder and of the rectum. 

Symptoms. The young parasites appear to do no injury ; in fact, 
even the adult worms seem to be inoffensive in themselves. The eggs, 
on the other hand, armed with a sharp point, are the exciting cause 
of the disease. The position of the parasite in the venous system, and 




Fig. 206.— The bovine 
blood fluke {Schisto- 
soma bovis) , male and 
female. X 9. (After 
Leuckart, 1894, p. 
467, Fig. 204 A.) 




Fig. 207. — Cross section of bovine blood fluke 
{Schistosoma bovis), showing the position of 
the female in the gynaecophoric canal. X 200. 
(After Leuckart, 1894, p. 472, Fig. 209.) 



the consequent location of the agglomeration of eggs, determine the 
jDarticular symptoms. Either the genito-urinary system is attacked, 
in which case heematuria is one of the first symptoms, or the large in- 
testine is attacked and blood is noticed in the faeces. 

If the parasites are lodged in the venous plexus of the genito-urinary 
system, the chief symptoms are : heematuria, pains in the lumbar region, 
the left iliac fossa, the thigh, or in the vulva, which may be spontaneous 
or may accompany micturition ; cystitis, vesical calculus, urinary fistulae, 
vaginal verminous tumours, nephritis. 

The eggs accumulate in the capillaries, which they rupture ; they 
traverse the mucosa and fall into the bladder, thus causing more or 
less haemorrhage ; in this way the hcEmatiivia is established, which is 



BILHARZIOSIS IN CATTLE AND SHEEP. 



441 



often the initial symptom. At first the urine is quite bloody, but it 
gradually becomes clearer, and it is only at the end of micturition that 
muco-purulent flakes are expelled, in which numerous eggs and even 
embryos are found ; the urine contains also epithelial cells, more or 
less pus, eggs, and occasionally embryos. On micturition sharp pains 
are felt at the base of the penis or at the gland, possibly due to the 
passage of eggs. The passage of eggs through the walls of the bladder 
gives rise to cystitis ; blood be- 
comes more abundant in the 
urine after fatigue or coitus ; 
clots may form and cause reten- 
tion of urine ; chronic urethritis 
may develop, evidently due to the 
presence of the eggs. In Egypt 
80 per cent, of the cases of vesical 
calculus in man coincide with 
bilharziosis ; the formation of the 
calculi evidently results from the 
presence of the eggs, for the cen- 
tral nodule always contains one 
or more of these structures. 
Urinary fistulge, opening on the 
perineum, more rarely into the 
rectum, occasionally form. The 
mucosa of the vagina, also of the 
uterus and bladder, becomes im- 
pregnated with calcareous salts. 
Nephritis develops in grave cases. 

If the parasites lodge in the 
veins of the rectum the lesions 
caused are analogous to those 
described for the genito-urinary 
tract. 

The heart, lungs, and liver generally remain normal. 

Pathology. The bladder is reduced in size, while its w^all is greatly 
thickened, due chiefly to hypertroi3hy of the muscularis ; the mucosa 
is also thickened, and at certain points it is indurated by uric or cal- 
careous deposits, but the principal lesion consists in ulcerations covered 
with sanious pus. Lesions analogous to those of the bladder are also 
observed in the low^er third of the ureters, and may extend as high as 
the kidney ; the ureter is enlarged and tortuous ; the mucosa irregular ; 
its lumen may remain nearly normal in size, but its wall becomes very 
thick : the flow of urine may be obstructed ; in short, a veritable 




Fig. 208. — Eggs of bovine blood fluke 
{Schistosoma hovis), showing the pecu- 
liar process on the end. a, b, Layers of 
the oviduct; c, eggs in the oviduct X 180 ; 
X, eggs deformed by pressure ; y, spinous 
process on end of egg x 700. (After 
Sonsino.) 



442 DISEASES OF THE BLOOD. 

hydro-nephrosis obtains, which results in atrophic lesions of the kidney, 
and may finally end fatally. 

The mesenteric lymphatic glands may hypertrophy, their substance 
becoming tumefied, presenting small hsemorrhagic centres, and contain- 
ing eggs. The liver may contain eggs and become somewhat cirrhotic; 
the eggs accumulate in the branches of the portal veins, or after 
piercing the walls they lie in the hepatic parenchyma. The lungs 
may also contain eggs. 

Diagnosis. The diagnosis may easily be made by a microscopic 
examination of the urine to determine the presence of the egg. 

Prognosis, etc. The severity of the disease varies directly with the 
number of parasites (and hence the number of eggs) in the body. 
Fortunately, in the majority of cases, the number of parasites is small, 
though it may increase from repeated infections to 500 or more. In 
cases of comparatively light infection the disease is reduced to a slight 
chronic cystitis, with now and then exacerbations, in course of which 
a slight amount of blood and pus is passed in the urine. The disease 
may last for years without apparent increase. In the most severe cases 
death may occur from various causes, rupture of the bladder, ascending 
pyelo-nephritis, uraemia, albuminuria; the patient may die in marasmus, 
being exhausted by the dysentery or the anaemia. 

Bilharziosis is accordingly not such a fatal disease as has sometimes 
been supposed. 

HEAT STROKE-OVER'EXERTION. 

In oxen and sheep heat stroke is rare as a primary accident, but it is 
frequently produced by over-exertion resulting from the combined action 
of the sun's rays, heat, and fatigue due to work or travelling. 

It is commonest during the hottest months of the year in oxen doing 
hard work or in flocks which have been travelled considerable distances. 
It may also be seen during cooler seasons as the result of exceptional 
fatigue. 

The disease results from a general intoxication which reacts most 
markedly on the cerebro-spinal centres. It is in fact a complex 
intoxication resulting from failure of the natural excretory organs to 
perform their function completely, and from excessive central heat 
acting on the nervous centres. 

Fat animals out of condition are more readily attacked than work- 
ing animals or sheep reared in the open air. 

The symptoms are very characteristic. Oxen when attacked first 
of all show extremely rapid respiration and dyspnoea, announcing pro- 
gressive asphyxia. They move with the nostrils dilated, the eyes 
prominent and injected, the mouth open and the tongue lolling out. 



HEAT STROKE — OVER-EXERTION. 443 

Then all of a sudden they come to a stop beside a wall, or, if at liberty, 
in a ditch, and refuse to move. They may die rapidly with symptoms 
of asphyxia if they are forced to move until completely exhausted. 
In others, after a rest of several hours, the breathing becomes slower, 
the anxiety less and normal conditions return. 

In sheep the same general signs may be seen : panting respiration, 
cyanosed mucous membranes and extreme anxiety, while death folloAvs 
ra]3idly in the same way, with symptoms of asphyxia. 

The diagnosis is extremely easy. The prognosis is grave. 

Treatment consists in prompt and free bleeding to prevent pulmonary 
congestion. The animals should be rested in a shady, sheltered spot. 
They should have cool drinks and be sprinkled over the head, neck, or 
entire surface of the body with cold water. 

To prevent such attacks, fat animals should not be moved for long 
distances, or during the hottest hours of the day, while difficult and 
}3rolonged exertion should be avoided. 



CHAPTER VI. 

DISEASES OF THE LYMPHATIC SYSTEM, 

Diseases of the lymphatics are numerous, highly important, and 
still imperfectly understood. They follow various accidents, local 
inflammations, certain specific diseases, such as tuberculosis, and may 
occur in an isolated form without involving any other part of the body. 



Gn.EPA, 




Gi.5M. 



Ga.5A. 



Fig. 209. — Superficial lymphatic glands of the head and neck. P, parotid gland 
GZ.SM, submaxillary gland ; Go-SG, subglossal gland ; GaPPA, preparotid gland 
G<xSA, subatloid gland ; GaPS, prescapular gland ; GaPPE, prepectoral gland 
J, jugular; 1^^ C, first rib. 

Inflammation, usually of infectious origin, may attack lymphatic 
vessels (lymphangitis) or lymphatic glands (adenitis), giving rise either 
to simple lymphangitis, suppurative lymphangitis, or again to simple 
or suppurative adenitis. 

It is unnecessary to emphasise this point in general surgical pathology, 
for it is identical with that which is observed in other domestic animals, 
but in order properly to detect the glandular symptoms in certain 



DISEASES OF THE LYMPHATIC SYSTEM. 



445 



diseases peculiar to the lymphatic apparatus, and in certain specific 
diseases, such as tuberculosis, farcy of the ox, etc., it is necessary to 
understand thoroughly the topography of the lymphatic system. 

Topography of the lymphatic glandular apparatus : Examination. 

The lymphatic glands are in some cases superficial, in others deep seated, 
and are arranged symmetrically on either side of the body. 

Beginning with the head and fore quarters, the lymphatic apparatus 




Fig. 210. — Deep-seated lymphatic glands-of the head and neck. The posterior portion 
of the lower jaw removed. P, pharynx ; G'Rp, retro-pharyngeai gland ; GC, deep 
cervical glands (cervical chain) ; NS, spinal nerve ; NP, pnenmo-gastric nerve ; 
GCs, superior cervical nerve ganglion; NMi, inferior maxillar}^ nerve. 

comprises a subgiossal, a preparotid, a subatloid, a prescapular and 
several prepectoral glands (Fig. 209). 

None of these glands are very deeply placed, and all are easily 
accessible to palpation, provided their exact position is known and 
the animals are not too fat. 

The subatloid is a little more difficult to detect, but in thin animals 
the tips of the fingers can easily be passed under the wing of the atlas 
so that the condition of the gland can be examined. 

In a normal condition, any gland on being examined conveys a 
sensation of softness and elasticity of a special character which never 
varies. Palpation is painless. 

When, however, the gland is diseased, palpation causes pain in the 
case of all acute affections. It may, indeed, be impossible to reach 



U6 



LYMPHATIC SYSTEM. 



the glands, as they are buried sometimes in oedematous swelHngs of 
varying size. On the other hand, they may be painless on being 
touched, but swollen, hypertrophied, indurated, hardened or caseous. 

The deep-seated glands of the fore portion of the body comprise 
the retrO'pharyngeal and the cervical chain running along the posterior 
border of the trachea. Normally these glands cannot be examined 
(Fig. 210) ; but when the seat of certain morbid processes, they may 
be so enlarged as even to be readily visible. The larynx and pharynx 
are then displaced downwards, the depression between the head and 



G.A 



&.J 



G.T. 



G.P 



\^X' 




J\ 



G.G 



Fig. 211. — Lymphatic glands of the hind quarter. GG, Precrural lymphatic gland; 
GF, lumbar lymphatic ; GP, popliteal lymphatic (deep-seated) ; GI, ischiatic 
lymphatic (deep-seated) ; GA, anal lymphatic (deep-seated). 



upper extremity of the neck disappears, together with the depression 
known as the jugular furrow. Such deformities may be either per- 
fectly symmetrical, as in lymphadenia, or (as is more commonly the 
case) asymmetrical, as in tuberculosis ; and if inspection leaves any 
doubt, the glands may be further examined by palpation. 

To obtain the fullest information both hands should be used, one 
arm being passed over the neck and the fingers engaged behind the 
trachea. The operator may also stand in front of the animal, whose 
head should be lifted so that the points of the fingers can be thrust 
deeply inwards on either side of the trachea in the direction of the 
vertebral column. 



DISEASES OF THE LYMPHATIC SYSTEM. 



447 



In the posterior portion of the body the number of glands that 
can be examined is much smaller. The gland of the stifle, also called 
" gland of the flank," is, so to speak, the only one which can readily 
be detected by examination or palpation. Nevertheless, in cases of 
lymphadenitis, tuberculosis of the glands, etc., it becomes easy to 




detect lymphatic glands in the loose fold of skin known as the flank. 
These glands are very small, and three in number. They are arranged 
in a triangle, one being much more prominent than the two others. 
In exceptional cases, little nodular glands, indistinguishable at ordi- 
nary times, may become hypertrophied. This is particularly true of 
the small glands in the neighbourhood of the last rib. 

The retro -mammary glands need only be mentioned, but it is 



448 LYMPHATIC SYSTEM. 

important to know that a deep-seated popliteal gland £ exists 
above the semi-tendinosus and semi-membranosus muscle in tnicK- 
ness of the muscles of the thigh; as also an ischiatic glan opposite 
the ischiatic notch, which can only be examined by inter:"^^ palpa- 
tion from the pelvis, and an anal gland situated deeply or^ siaes 

and in front of the sphincter ani. 

With the exception of those of the pelvis and of the sublumbar 
region, the glands of the thoracic and abdominal cavity ^^^^^^^ ^^ 
examined, but change in them is indicated under certaP circuna- 
stances by clearly defined clinical symptoms, and mor€^^^^^ ^ ^^ 
necessary to be able to detect changes in these glands on pc^^ "■'^■^^^ ^""^ 
examination. 

In the thoracic cavity the lymphatic apparatus com^P^^^®^ ^ 
mass of the prepectoral glands, which extends into the ante'^"^^^ ^^ ^" 
astinum between the first ribs (glands of the entry to the _^ ^^ ^' ^ 
aortic lymphatic gland situated beneath the dorsal port:^^^ ^ ^ 
spine opposite the bifurcation of the aorta, and the lymph^ ^^ g an s 
of the posterior mediastinum, one of which is relatively si"*^^ ^^^ ^^ 
lodged in the concavity of the posterior aorta, the other P^S^' ^ ^^' 
gated and situated immediately above the oesophagus m f 
passage through the diaphragm. 

In the abdominal cavity a sublumbar chain is found s'^ '^^ ^ ^^ 
the sides of the lumbo-sacral portion of the vertebral cc^ ^ni^? ^ 
mass of the subsacral lymphatic glands, and, at the entra'^^^ ^ /. ^ 
pelvis, extending on either side along the course of the ex: ^^^^ ^ ^^^ 
arteries and veins and resting on the shafts of the iliac ^^^^^' ^ 
iliac glands. 

All these glands are partly accessible to examination by t ^ ^^^ ^^' 

Last of all, we may mention the gland situated on th^^ ^ ^""^ ^ 
the liver, the mesenteric glands, and the Httle lymphatic gL^^^^ ^^°^^ 
the sternum. 

In the front limb the only glands of importance from^ ^ ^ mica 
standpoint are those of the internal surface of the shouldi^""^' ^ ^^^ ^ 
the divisions of the brachial plexus. 

When enlarged or invaded by any specific organism, ^^ ^^^J? 
by compressing the nerve trunks, cause lameness. 



THE LYMPHOGENIC DIATHESIS. 

(lymphadenitis, lympho-cythzemia, myelo-cyth^mi/ 



It has been questioned whether the term " lymphogenic .' 

which was employed in human medicine by Jaccoud to descr. 
morbid conditions also found in animals of the bovine s]3ec'^^ ' 



THE LYMPHOGENIC DIATHESIS. 449 

continue in use. At the present moment it is difficult to determine 
the question. Under any circumstances it has the advantage of 
inchiding diseases of the lymphatic system, indicated by hypertrophy 
of the lymphatic gjands (adenitis) or by an exaggerated production of 
white blood corpuscles (leucaemia), and the passage into the general 
circulation of products derived from the lymphatic apparatus. For 
these reasons it may be employed here. 

Clinical investigation long ago demonstrated that in man certain 
pathological conditions were characterised by a peculiar colour of the 
blood, due to the presence of white blood corpuscles in excessive 
quantities, whence the names " leucaemia " (Yirchow) and " leuco- 
cythsemia " (Bennett). In the same way it has been shown that the 
change in the blood characterised by a superabundance of white blood 
corpuscles generally coincides with engorgement or more or less 
marked hypertrophy of the lymphatic system and of the adenoid 
tissue of the body (lymphatic glands, spleen, bone marrow, and, in 
exceptional cases, liver, kidneys, etc.) — leuco-cythaemic lymphadenitis ; 
but that many cases also occur in which this hypertrophy of the 
adenoid tissue or of the lymphatic gland tissue may exist, without 
any excessive number of white blood corpuscles in the blood, whence 
the name " aleucsemic lymphadenitis or pseudo-leucaemia." Cases of 
true leucaemia without adenitis are much rarer, the lesions therein 
being confined to the adenoid tissue of the bone marrow. 

These three morbid conditions — leucaemic lymphadenitis, or leuco- 
cythaemia ; aleucaemic or pseudo-leucaemic lymphadenitis, or more 
simply adenitis ; and true or simple leucaemia — are frequently found 
in the bovine species. Whilst stating that these diseases are frequent, 
we must, however, be understood to except the numerous cases of 
tuberculous lesions formerly included under the same head. 

Jaccoud has shown that in reality the causes of these three morbid 
conditions are very similar, and that a case which at first appears to 
be of the nature of aleucaemic lymphadenitis may later become trans- 
formed into leucaemic lymphadenitis ; or, inversely, that a case which 
at first appeared to be a simple leucaemia might often become com- 
plicated with lymphadenitis : hence the grouping of these different 
morbid conditions under the heading of lymphogenic diathesis. 

Investigations have now thrown more light on the subject because of 
the more perfect recognition of the varieties of white blood corpuscles, 
and the above-mentioned morbid conditions may be defined as follows : — 

(1.) The first variety consists of a more or less marked adenitis or 
lymphadenitis without leucaemia (aleucaemic lymphadenitis). 

(2.) The second variety, consisting of leucaemic lymphadenitis, or 
leuco-cythaemia, is a lymphatic lucaemia or lympho-cythaemia, the 

D.C. G G 



450 LYMPHATIC SYSTEM. 

anatomical characteristic of which is enlargement of lymphatic glands, 
and the histological characteristic increase in number of the large 
and small lymphocytes. 

(3.) A third variety, formerly regarded as simplq^ leucaemia without 
lymphadenitis, is myelogenic leucaemia or myelo-cythaemia, the ana- 
tomico-pathological characteristic of which is to be found in myeloid 
hypertrophy of the bone marrow, giving to the bone marrow on post- 
mortem examination a puriform appearance, and in the myeloid 
condition of the sjDleen. 

Histologically this variety is characterised by an absolute increase 
in numbers of the large mono- and poly- nuclear eosinophile leucocytes. 

Symptoms. Simple lymphadenitis begins in an insidious manner, 
and is characterised by weakness, anaemia, paleness of the mucous 
membranes, and wasting without apparent reason, although the appe- 
tite is preserved. It is only at a later stage that the glandular enlarge- 
ments are discovered (adenitis), and often this discovery is not made 
until the veterinary surgeon is called in. 

The existence of the disease is indicated by enlargement of the 
superficial glands, and this enlargement, wbich may commence at any 
point, extends along the course of the lymphatic vessels to the neigh- 
bouring glands, until in a shorter or longer time it involves all the 
lymphatic glands in the body. 

The enlargement of the glands is usually symmetrical, and on 
clinical examination it is sometimes easy to detect at the outset 
an increase in size of the retro-pharyngeal glands, the glands of the 
neck, the prescapular glands, the glands of the flank, etc. 

Kectal exploration reveals hypertrophy of the glands of the pelvis 
and of the sublumbar region, etc. The animals waste very rapidly, 
and sometimes in a few months become incapable of standing. They 
develop cachexia, and die in a state of exhaustion, with no other lesions 
than those of lymphatic hypertrophy. Neither do they exhibit any 
marked increase in the number of white corpuscles in the blood. 

In lympho-cythaemia the beginning of the disease is often identical 
with that of simple lymphadenitis, the increase in the number of white 
blood corpuscles not occurring until later. In other cases, on the con- 
trary, leucaemia appears first, and the enlargement of the lymphatic 
gland follows ; but what characterises this form and allows of it being 
distinguished from myelo-cythaemia is the great increase in the number 
of large or small lymphocytes. The development is identical with, and 
sometimes much more rapid than, that of the preceding form. The 
animals waste away and become anaemic and cachectic, dying at last 
in a state of absolute exhaustion. 

Post-mortem examination reveals, as in the previous condition, 



THE LYMPHOGENIC DIATHESIS. 451 

symmetrical hypertrophy of all the lymphatic glands ; the spleen is 
very often enormous, and the liver is sometimes affected, as are also, 
in exceptional cases, the kidneys. 

It may happen that the spleen alone appears affected, or at least 
that it has been first attacked, a fact which explains the existence of 
leucaemia before any enlargement of the lymphatic glands. 

Causation. The causes of lymphadenitis and of lympho-cythaemia 
are unknown in veterinary as in human medicine. Apparently these 
diseases are more common in adults than ia young animals. Some 
regard them as infectious in character, but this can hardly be the 
case, as all experimental attempts to transmit the diseases have failed. 
It is more plausible to compare the development of these morbid 
conditions with that of malignant tumours, and although some doubt 
still exists, simple lymphadenitis may be described as an aleucsemic 
lymphoma or lympho-cytoma, w^hich has gradually become generalised, 
spreading by way of the lymphatic channels from the gland first affected 
through the surrounding glandular system. Lympho-cythsemia, on the 
other hand, may be said to be a leucsemic lympho-cytoma, which spreads 
both by the blood circulation and by the lymphatic paths (spleen, 
haematopoietic glands and organs). 

This view of the development of the lesions enables us to class 
lympho-sarcomata with lymphomata and lympho-cytomata. The 
malignant character and extremely rapid development of lympho- 
sarcomata appear due to its extending by contiguity of tissue, and 
simultaneously by the lymphatic paths. 

This new grouping would consequently place on one side myelogenic 
leucaemia, also called myelo-cythaemia, which is perhaps a different mor- 
bid species. This would destroy the unity implied in Jaccoud's theory 
of the lymphogenic diathesis ; but for all that this method of grouping 
might be justified by reference to specific cellular characteristics. In 
myelo-cythaemia the disease appears to commence as a lympho- 
cythaemia, i.e., it is unaccompanied by enlargement of lymphatic 
glands or hypertrophy of the spleen or liver, though the blood ap- 
pears leucaemic. The condition is not a leucaemia due to lympho- 
cytes, but rather a leucaemia produced b}^ mono- and poly- nuclear 
eosinophile leucocytes, i.e., leucocytes derived from the bone marrow. 

The patients are carried off rapidly after persistent wasting, decline 
and cachexia, whilst on post-mortem examination the puriform aspect 
of the bone marrow is an extremely striking characteristic. 

Diagnosis. There is rarely much difdculty as regards the diagnosis. 
The enlargement of the lymphatic glands, for instance, can readily be 
detected, and the only disease with which this can possibly be confounded 
is tubercular enlargement. 

GG 2 



452 LYMPHATIC SYSTEM. 

With the meaDs at present available for diagnosing tuberculosis, 
such as microscopic examination of the discharge, inoculation with 
discharge, examination of material from the glands, injection of 
tuberculin, etc., the nature of the disease can always be placed 
beyond doubt. 

In lympho-cythffimia and in myelo-cythgemia, the whitish-violet 
lactescent appearance of the blood is of unmistakable significance, 
particularly when the manifest progressive wasting of the whole 
system is taken into account. 

Histological examination of the blood after fixation and staining 
will in the former cases reveal the presence of very large numbers of 
lymphocytes, and in the latter an absolute increase in the number of 
the mono- and poly- nuclear lymphocytes. It should be easy, therefore, 
to distinguish the two diseases, especially as other symptoms vary. 

In the early stages leucsemia may be mistaken for the leueocytosis 
seen in infectious diseases. These forms of leueocytosis are very com- 
mon in animals of the bovine species. They occur in certain forms of 
tuberculosis, in uterine infections, in cases of internal suppuration, in 
tumour of the heart, the rumen, etc., and vary in so far as one style or 
another of white blood corpuscle predominates. The diagnosis, there- 
fore, necessitates that the white blood corpuscles should be counted, and 
whenever it is found that their variations in number are no more than 
between 5,000 and 15,000 per cubic millimetre, the case may be regarded 
as one of temporary leueocytosis. 

If, on the other hand, those corpuscles number more than from 
15,000 to 20,000, or, as may sometimes hajDpen, they attain to from 
200,000 to 300,000 per cubic millimetre (one white to two or three 
red blood corpuscles), the case is one of leucffimia, and, according to 
the predominance of the particular type of cell, it is a lympho- 
cythaemia or a myelo-cythaemia. 

In leucaemic conditions the red blood corpuscles are also present 
in fewer than the normal numbers. "They are more irregular, assume 
giant and dwarf forms (macrocytes and microcytes), sometimes exhibit 
lacunae, and are always polychromatophile, i.e., without special affinity 
for any particular constituent of double or triple stains. 

Prognosis. The prognosis of diseases included in the lymphogenic 
diathesis is extremely grave, and in the present state of our knowledge 
it may be assumed that sooner or later death is inevitable. 

Treatment. Treatment can scarcely be considered to exist, for at 
the best it can only delay the development of the disease. Neverthe- 
less, and with this reservation, it is certain that preparations of iron, 
iodine and arsenic have a certain effect, probably by acting on the 
hsematopoiesis. 



GOITRE IN CALVES AND LAMBS. 453 

CASEOUS LYMPHADENITIS OF THE SHEEP. 

In the sheep the lymphatic glands are sometimes the seat of peculiar 
changes, which do not appear to have any marked effect on the general 
condition. Thus a post-mortem examination or an examination of 
animals in the slaughter-house sometimes shows a certain number of 
isolated or symmetrical glands, such as the mediastinal, tracheal, in- 
guinal, pelvic or sublumbar glands, to be greatly enlarged and completely 
degenerated. The precrural, prescapular, and popliteal glands are said 
to be most frequently affected. Their contents are caseous and yellowish, 
enveloped in a fibrous sheath, and show no signs of peripheral inflam- 
mation. The other organs and viscera may either be healthy or exhibit 
caseous lesions identical with those found in caseous broncho-pneumonia. 

The causes of this disease are imperfectly understood, although 
Cherry and Bull (1899, the Veterinarian, Vol. LXXIL, No. 860, p. 523) 
have isolated from the lesions an organism identical with Preisz's 
bacillus and with the microbe of ulcerative lymphangitis in the horse. 

Norgaard and Mohler (Annual Report, United States Bureau of Agri- 
culture, 1899, p. 638) have studied the disease. In June, 1897, Turski, 
at Danzig, found about 150 breeding ewes, from eight to twelve years 
old, suffering from nodules or abscesses the size of a child's fist in the 
inguinal and prescapular regions. They had been sold for slaughter, 
and many were in very poor condition. The disease occurs in Europe, 
Western America, South America, and Australia. Several thousand 
cases are annually seen in the slaughter-houses of the United States. 

The symptoms generally escape notice, and it is only by accident 
that one sometimes detects marked enlargement of the lymphatic 
glands of the neck or of the superficial inguinal glands. The patients, 
moreover, may remain in very good bodily condition, so that the 
lesions are only discovered on the meat being inspected. 

Having regard to our imperfect knowledge of this disease, it is 
impossible to express an opinion as to its importance or treatment. 

GOITRE IN CALVES AND LAMBS. 

Although not strictly relevant to the foregoing matter, a few remarks 
may here be made on the subject of goitre. 

True goitre consists in hyperplasia of the follicles of the thyroid 
gland, with colloid change of their contents, which are chiefly albu- 
minous. The swelling is mainly due to enlargement of the follicles, 
and is termed struma follicularis. It may attack the entire organ 
or only one-half ; less frequently it is confined to certain sections. 
Other varieties of goitre are recognised, such as fibrous, varicose and 
cystic goitre. (For fuller details see Moller and Dollar's " Eegional 
Surgery," p. 149.) 



454 



LYMPHATIC SYSTEM. 




GOITRE IN CALVES AND LAMBS. 455 

Treatment by injection of thyroid juice or by feeding on thyroid 
extract has given better results than drugs. 

The following account of an outbreak in New Zealand is sum- 
marised from the Annual Keport of the Chief Veterinarian of New 
Zealand, 1901 :— 

The calves affected were born with enlarged thyroids. The farm is 
of rich alluvial deposit, and rather below the level of the river, which it 
borders. The land has been in occupation, however, for many years, 
and no similar condition had been previously noted. At first, as calves 
only were affected, it was thought possibly to be due to the bull, a two- 
year-old animal, but when a foal was born suffering from a similar mal- 
formation this theory naturally fell to the ground. 

The land had been ploughed with a special plough 20 inches 
deep, but this is no uncommon practice in the island. 

About the same time, a similar disease was discovered affecting 
lambs at a farm near Outram. From 450 ewes, 150 lambs had been 
lost, the glands being enlarged to the size of a cricket ball. A few 
had been born dead, many only lived a few hours, others lived several 
days, and a considerable number recovered. There was no connection, 
directly or indirectly, between the two farms, they being at least fifty 
miles apart. A few of the calves died or were killed, the remainder 
recovered, and the foal grew rapidly better. The land on both farms 
is very similar in composition. 

Mr. Wilkie states, from observation of previous cases in lambs, that 
" it appears to be always associated with malnutrition and a condition of 
ansemia in the parent, induced in most cases by feeding with watery, 
innutritious foods." 

Specimens were forwarded, from a calf and from a lamb, of enlarged 
glands. The gland of the calf was enormously enlarged, being at least 
twice the size of an orange, dark in colour, flabby in consistency, and 
on section a mucous material exuded copiously from the cut surface. 
Micro-examination showed the acini to be larger than normal, filled with 
the usual mucous material, and lined with cubical epithelium. The 
connective tissue surrounding the alveoli was, however, crowded with 
round-cells, so much so that the whole parenchyma seemed to be 
practically composed of these cells. 

A specimen of an enlarged thyroid from the lamb was about the size 
of a sheep's kidney, and very much the same shape and colour. Sections 
microscopically examined showed a different condition to that of the 
calf's thyroid. Here the acini were filled with epithelial cells loosely 
arranged as if the lining epithelium had been proliferating rapidly, 
while the connective tissue surrounding the acini was fairly normal. 
The section had a somewhat adenomatous appearance. 



SECTION V. 

NERVOUS SYSTEM. 
CEREBRAL CONGESTION. 

According to Crnzel, cerebral congestion is somewhat frequent in 
working oxen subject to continued concussion from the yoke, especially 
among animals working on a rocky soil. The condition may also be 
produced by prolonged exposure to the sun, as well as by sudden and 
intense cold. 

Passive cerebral congestion by stasis may be produced by any cause 
markedly interfering with the return circulation (pericarditis due to 
foreign bodies). Clinically it is of no importance. 

The animals, previously in good health, suddenly appear comatose. 
They are insensible to stimulation of any kind, the head is rested on any 
convenient object or is held stationary, the animal looks drowsy, the 
gait is hesitating or vacillating, the respiration slow or irregular. Left 
at liberty, the animal does not seem to know where it is going ; indeed, 
sometimes it is absolutely blind and strikes against any obstacle in its 
path, or falls and suffers from epileptiform convulsions. The cranial 
region is abnormally warm. The course of the attack is rapid, and 
the animal either dies in a state of coma or convulsions or else re- 
covers rapidly. 

Diagnosis. The diagnosis is decidedly difficult; and the prognosis 
should be reserved. 

Treatment commences with free bleeding, the amount of blood 
drawn being proportioned to the animal's size. The sides of the body 
may then be stimulated and a purgative administered. 

MENINGITIS. 

The generic term '' meningitis " includes all inflammations of the 
arachnoid, pia mater and internal surface of the dura mater. 

These forms of inflammation occur in diseases such as tuberculosis 
and in parasitic diseases of the brain. Under other circumstances, they 
are rare, and may be produced by very varying causes. 

An epizootic cerebro-spinal meningitis of the bovine species has 



MENINGITIS. 457 

also been described, principally in Germany. It seems almost mi- 
known in France, and French literatm-e contains no well-authenticated 
case. 

Fm'thermore, an epizootic cerebro-spinal meningitis of sheep, or 
rather of lambs, has been described in Germany, in Italy, and in 
France. These descriptions are all open to many objections. It 
seems that under the term "cerebro-spinal meningitis" have been 
grouped cases of enzootic tetanus, doubtful cases of poisoning, and 
particularly cases of coenurosis in the first stage of development. We 
therefore discard these descri]3tions, which differ too much among 
themselves to be of any value. 

Causation. Meningitis occurs in the ox and sheep as a complica- 
tion of wounds in the cranial region, accompanied by fissuring of the 
bone, periostitis, abscess formation, etc. 

It is also seen as a complication of fractures of the horns, and old- 
standing catarrh of the facial sinuses. In the sheep it follows parasitic 
catarrh due to the larvae of oestridae. 

The meningitis appears, according to circumstances, in the forms of 
local meningitis, anterior frontal meningitis, basilar meningitis, etc. 
Finally, it may develop as a complication of different diseases, such as 
gangrenous coryza, purulent infection, subparotid abscess, suppurative 
phlebitis, suppuration of the eye or of the orbit, etc. 

Symptoms. It is difficult to detect and interpret the first symptoms 
shown, because these chiefly consist in dulness, want of appetite and 
constipation, without any particular fever. At a later stage, excessive 
excitability is produced by noises, by changes of light, or by handling. 
Careful examination of the patients shows a change in their expression, 
rapidly followed by contraction and inequality of the pupils or deviation 
of the visual axis (strabismus, squinting). The pulse becomes irregular, 
as also the respiration. The appetite is entirely lost, and it is not 
uncommon to note a contraction of the muscles of the neck and jaws, 
as well as inability to move about and symptoms similar to those of 
dropsy of the cerebral ventricles. 

The chronic form is rare. 

Lesions. The lesions comprise local or general hyperemia and 
exudative inflammation of the pia mater and arachnoid, together with 
the formation of false membranes or of pus in the subdural space. 
The meninges are partially adherent, and the superficial layers of the 
brain are also inflamed by contiguity of tissue. 

Diagnosis. The diagnosis must be based on the disturbance of 
vision, movement, and appetite, and on the course of the symptoms, 
as well as on the external signs in the case of such diseases as are 
prone to become complicated with meningitis. 



458 NERVOUS SYSTEM. 

Prognosis. Sooner or later the case is likely to end fatally, and 
there is no practical use in treating the patient. 

Treatment. If in exceptional cases slaughter is objected to, setons 
and blisters may be applied to the poll or the parotid region, or the 
parts may be enveloped in ice bags or compresses of iced water 
frequently renewed. 

ENCEPHALITIS. 

Encephalitis, i.e., inflammation of the cerebral substance, is very 
closely allied to meningitis ; in a great number of cases meningitis 
and encephalitis co-exist. In other cases encephalitis may be found 
apart from meningitis, and vice versa. Moreover, many of the symp- 
toms of meningitis are to be found in cases of encephalitis. 

Encephalitis may develop as a complication of meningitis. Ence- 
phalitis may also follow abundant parasitic infestation, as in coenurosis 
(which will be particularly studied as it affects sheep), or microbic 
infection, the commonest form of which in the ox is tuberculosis. 
The encephalitis may be diffuse or circumscribed, according to the 
cause, while the symptoms are varied and numerous. Very frequently, 
particularly in cases of tuberculosis, encephalitis assumes a chronic 
form. 

Symptoms. The earliest symptoms are extremely difficult to detect, 
because they are scarcely characteristic and because it is impossible 
to ascertain the sensations of the animal. 

It is only when the disturbances in walking, in the eyesight, in 
swallowing, etc., are noted that suspicion is aroused. 

The symptoms may appear suddenly. Nevertheless it is beyond 
doubt that there are certain slightly marked prodromata, indicated by 
diminution of appetite, wasting, and changes in vision. Soon afterwards 
occur other forms of disturbance, which may be classified under the 
heading of ^' motor, visual, nervous, and impulsive." The patients 
appear stunned, their movements are slow and hesitating, they par- 
tially lose control over their limbs and display lameness, with spasmodic 
movements of one or two limbs. Examination of the joints shows no 
injury. The lameness may simultaneously affect two diagonal limbs 
or two fore and two hind limbs, or even three limbs. This lameness 
is of central origin. 

The ocular disturbance is marked by diminution or loss of vision, 
by strabismus, or by frequent unconscious movements of the eyes and 
eyelids, and also more particularly by inequality, contraction or dila- 
tation of the pupils. 

Nervous, impulsive disturbance is most readily noted when the 
animals are at liberty. Even when the sight remains, they seem 



CEREBRAL TUMOURS. 459 

quite incapable of avoiding obstacles or as though absolutely forced 
to move to the right or left, etc. 

Attacks of giddiness, moreover, are not unusual under the influence 
of the slightest excitement. During such attacks the animals thrust 
the head against a wall, or the}^ involuntarily recoil or make lateral move- 
ments. In many cases these vertiginous attacks end by the animal 
falling and showing epileptiform convulsions, during which it may die. 

The symj)toms are never the same in two different animals, but 
they ma}^ easily be classed according to the above indications. The 
indications furnished by the condition of the eyes and by the peculiar 
impulsive movements are particularly significant. 

On the other hand, there are modifications in breathing without 
apparent local cause, and difficulty or even impossibility of swallowing, 
etc., although there exists no material obstacle. 

Diagnosis. The condition is often confused with meningitis, and 
the mistake is not serious, because meningitis and encephalitis fre- 
quently accompany one another. 

Prognosis. The prognosis must be regarded as fatal. The patients 
very seldom recover, and there is no reason for keeping them alive. 

Treatment. Here, again, blisters may be applied to the upper 
extremity of the neck, or setons may be passed. Cooling applications 
to the cranial region have also been suggested. None of these 
methods produces more than a temporary palliative effect. 

CEREBRAL TUMOURS. 

The brain may be injured and compressed by various tumours of 
other than parasitic origin. Such tumours may originate in the 
bones, the meninges or the choroid plexus, or they may simply be 
due to generalisation of a previously existing tumour. Whilst of 
very varied origin and nature, all tumours of the cranial cavity have 
one common effect, viz., to compress the brain. This continuous 
compression causes progressive atrophy of the brain, but its exist- 
ence is not always suspected, because the lesions may not give rise 
to any marked symptoms. 

The hind portions of the hemispheres and the white substance 
are generally very tolerant. The front portions, on the other hand — 
the frontal lobes and the grey substance — resent compression, which 
provokes various symptoms in consequence. 

The symptoms of compression and atrophy of the brain differ 
greatly, a fact which is easily understood, inasmuch as the seat of 
the change may var}^ and therefore it is possible only to trace the 
chief manifestations, which suggest the existence of a cerebral tumour. 



460 NERVOUS SYSTEM. 

The general changes are indicated by signs precisely similar to 
those so common in horses with dropsy of the ventricles (general 
depression, inability to back, long intervals between the prehension 
of successive mouthfuls of food, sudden cessation of mastication, etc.), 
by an impulsive or automatic gait, and by the assumption of strange 
attitudes (kneeling down in front, etc.). When at rest the animals 
appear to be in a state of continual torpor. 

Special symptoms sometimes occur, which enable the seat of the 
injury to be localised in more or less exact fashion. These symptoms 
affect the vision (amblyopia, amaurosis, strabismus, nystagmus), general 
sensibility (hyperaesthesia, anaesthesia, etc.), and the power of move- 
ment (total, partial or crossed hemiplegia, want of co-ordination of 
movements, etc.). 

Trifling stimuli almost always lead to marked and even epilepti- 
form attacks. 

The diagnosis of cerebral tumours is .very difficult, particularly 
when attempts are made to indicate their exact seat, but that of 
other cerebral lesions is somewhat easier. 

The prognosis is very grave, and in the case of domestic animals 
nothing can be done. In the ox intra-cranial operations are diffi- 
cult, by reason of the presence of the sinuses which obstruct the 
approach to the brain cavity ; economically surgical treatment is 
seldom advisable. 

INSOLATION, 

Insolation is an exceptional accident in animals of the bovine, 
ovine, or porcine species. If at liberty these animals move about, 
and always seek shelter when the sun is fierce. If, on the con- 
trary, they are harnessed and kept standing for long, exposed to the 
full midday sun during June, July or August, they may suffer from 
insolation. 

During the International Cattle Show attached to the Exhibition 
of 1900 in Paris, a considerable number of cases of insolation occurred 
in animals of one class, exposed to the full midday sun, in an ill- 
ventilated spot. The other classes only received sunlight from the 
sides, and in them not a single case occurred. 

Death may follow in a few hours; it is difficult to say precisely 
how it is brought about, but it is always accompanied by congestion 
of the cerebro-spinal centres and general blood stasis. 

The symptoms of the development of insolation occur very rapidly. 
In animals of the bovine species there is accelerated respiration, which 
soon amounts to dyspnoea. The mucous membranes then become 
cyanotic. The animals attacked seem anxious, although not agitated, 



I 



POST-PARTUM PARALYSIS — MILK FEVER — MAMMARY TOXEMIA, ETC. 461 

and soon afterwards the eyes ^Yate^, the mucous membrane and the 
hps of the vulva display oedematus infiltration and congestion, and 
areas of cutaneous congestion, closely resembling mud fever in the 
horse, appear over the mammae. At this stage the animals move with 
difficulty, and show all the symptoms seen at the outset of gan- 
grenous coryza. 

All these symptoms develop in one, two, or three hours, and death 
may follow if nothing is done. They disappear, however, as rapidly 
as they appear. In an hour or less we have seen in some cases a 
complete return to the normal condition. Given the facts, the 
diagnosis is extremely easy. 

Treatment. Treatment should be commenced by immediately re- 
moving the animal to a cool, airy, shady place. It may then be 
bled, and the head and neck should be freely drenched with cold water. 
The symptoms generally disappear as though by magic. 



POST-PARTUM PARALYSIS-MILK FEVER— MAMMARY TOXEMIA- 
PARTURIENT APOPLEXY-DROPPING AFTER CALVING. 

For a great part of the following short account we are indebted to an 
excellent report by J. J. Repp, Y.M.D., in the Journal of Comp. JMcdicine 
and Veterinary Archives, September, 1901 : — 

The word ''fever " in connection with the terminology of this disease 
is not very appropriate, because in the majority of cases fever is not 
present, but the animal has a subnormal temperature. The term milk 
fever is very misleading and indefinite, as it is also used by the laity to 
designate other diseases, such as parturient septicaemia and the various 
forms of mammitis. Parturient paralysis must be clearly differentiated 
from parturient septicaemia, which is a disease of an entirely different 
character and which may occur in any of the domestic species, w^hereas 
parturient paralysis occurs only in the cow. 

Distribution. Parturient paralysis occurs wherever milch cows are 
kept. It is more prevalent in dairy districts, because it is the heavy 
milking strains of cows that are most subject to the disease. 

Cause. No definite cause can be assigned for this disease. Schmidt's 
theory is that parturient paralysis is caused by the evolution in the mam- 
mary gland of a poisonous substance through the over-activity of -the 
epithelial cells of this gland excited by the determination to the udder 
after birth of large quantities of blood which was supplied to the uterus 
and the foetus before birth, but which now goes to the udder because 
of the natural demand for milk secretion. This poisonous substance 
being carried in the circulation to various parts of the body, brings on 
the symptoms which characterise the disease. It is well recognised that 



462 NERVOUS SYSTEM. 

living cells may, under certain circumstances, produce poisonous sub- 
stances. Schmidt's theory, therefore, is in accord with an established 
principle. 

Pathogenesis, or generation, of the disease. Parturient paralysis, 
as a rule, occurs in cows which give a heavy flow of milk and which 
are in a high state of nutrition. It may develop at any age, but is 
extremely rare in cows before they have reached adult age and have 
given birth to several calves. It is also rare in old coavs. It occurs, 
then, in cows which are of middle age and in the full height of their 
activity as milk producers. The disease attacks the cow after she has 
given birth to a calf, usually within twenty-four hours thereafter, but in 
some cases not until a week or even a month after parturition. In a few 
cases the disease has its inception a short time before parturition. Cows 
which are stabled and deprived of exercise are said to be more prone to 
the disease than those which are permitted to exercise at will. There 
are many exceptions to this statement, although it is the usual teaching. 
Further observation may show that it is not correct. In Iowa more 
cows take this disease while at pasture than in any other circumstance. 
This doubtless arises from the fact that in Iowa cows are given more 
freedom than is customary in older dairy States. The disease may arise 
at any time in the year, but, on account of the fact that spring-time is 
pre-eminently the calving season, most cases originate at this season. 

Morbid anatomy. The morbid alterations are limited and variable, 
and offer nothing characteristic. The blood is irregularly distributed, 
a condition which probably indicates marked vasomotor disturbance 
resulting from the profound interference with the nervous functions 
which accom23anies the disease. The abdominal organs are usually 
filled with blood. The brain may be anaemic, oedematous, easily torn, 
and yellowish in colour. In other cases it shows hyperiemia of the 
meninges and of the brain substance. 

Symptoms. The disease usually ap^^ears within twenty-four to forty- 
eight hours after parturition. In extreme cases it may not occur until 
two months or even six months after parturition. It may rarely occur 
before birth. It usually follows an easy birth. At the onset of the 
disease the cow manifests some uneasiness ; it moves about in a rest- 
less manner, stamps, strikes the abdomen with its hind legs, perhaps 
bellows, grinds the teeth, and may have spasms of groups of muscles 
or even a general convulsion. After this period, which may be un- 
noticed, the symptoms of paralysis come on. The cow shows weakness, 
staggers, and at last falls. As the paralysis advances it stretches on 
the ground, lying on its side usually with the neck bent to one side so 
as to bring the nose into the flank or the costal region. This is the 
characteristic position in jjarturient paralysis. If the head is brought 



. POST-PARTUM PARALYSIS — MILK FEVER — MAMMARY TOX.^MIA, ETC. 463 

into the normal position, it at once returns to tbe unnatural position in 
which it was found. The animal is in a state of partial or complete 
unconsciousness, does not respond to blows or calls, and takes no note 
of its surroundings. The eye is dull and not sensitive to the finger 
touch, sunken, pupil dilated, and the upper lid is drooping ; the tongue 
is paralysed, saliva runs from the mouth, the pharynx and oesophagus 
have lost the power of motion, so that the animal is unable to swallow ; 
the peristalsis of the stomachs and intestines is in abeyance, and as a 
result digestion is arrested, fermentation sets in, and the animal becomes 
tympanitic ; the contents of the rectum and colon are hard and dry, and 
may be covered with mucus or blood, urination is suspended ; the os" 
uteri is almost invariably dilated if the disease occurs within a day of 
parturition ; pulse -small, often imperceptible, 60 to 120 per minute ; 
temperature, usually normal or below normal, may be as low as 95° 
Fahr., in some cases may be as high as 105° Fahr. Such a high 
temperature probably does not occur in a case of pure parturient para- 
lysis, but only when there is a complication of parturient sej^ticaemia. 
The extremities are cold. The after-birth is sometimes retained. There 
may be accompanying prolapse of the uterus. 

Course. Without treatment, and, indeed, with most kinds of treat- 
ment which have been applied in the , past, the disease usually runs 
rapidly to a fatal issue. It lasts two to three days, and in some cases 
longer, the condition gradually becoming more and more aggravated. 
Death results from sudden failure of the heart or brain, and is often 
preceded by profuse diarrhoea. In milder cases the cow may linoer as 
long as two to four weeks and then die of pneumonia, which results from 
the inhalation, or introduction through attempts at medication, of foreion 
substances into the lungs during the period of paralysis of the pharynx 
and cesophagus. If recovery occurs, the animal is entirel}^ well in two 
to five days. In rare cases paralysis of the hind parts may persist for a 
long while. 

Diagnosis. This is made by a study of the history and symptoms. 
It is comparatively easy. 

Differential diagnosis. It must be distinguished from ante-partum 
paralysis, broken-back, parturient septicaemia ; but one familiar with 
the character of these diseases will find no difiiculty in makino- this 
differentiation. 

Treatment. This may be considered under two distinct subdivisions 
viz., preventive treatment and curative treatment. 

(a) Preventive treatment. — By considering what has been said under 
the head of " generation of the disease," one can easily infer what 
measures should be adopted to prevent the disease. Cows in the later 
stage of gestation should be fed moderately, grain especially being 



464 NERVOUS SYSTEM. 

given sparingly or entirely withheld ; the animals should be given an 
opportunity to take plenty of exercise ; the bowels should be kept 
in good condition by the administration of such salines as magnesium 
sulphate, sodium chloride, and sodium bicarbonate. The after-birth 
should be removed soon after parturition and several uterine douches 
administered. 

(b) Curative treatment, — The older methods of treatment comprised : 
warmth and friction to the mammary gland ; the administration of 
sedatives, such as opium, chloral and bromide of potassium ; stimulants, 
including ammonia, ether, turpentine and alcohol ; washing out the 
uterus with water or disinfectant solutions ; the relief of tympany by 
the use of the trocar and canula (by which instrument medicines may 
also be injected directly into the rumen) ; the removal of faeces from the 
rectum ; warm clothing of the body and general attention to the animal's 
comfort, and to the teachings of hygiene. For all these widely diversi- 
fied methods good results have been claimed, and, we may add, bad ones 
at times recorded. F. T. Harvey (Cornwall) estimates the average mor- 
tality at from 40 to 66 per cent., though he claims for his more recent 
practice a lessened mortality of only 20 per cent. 

Schmidt does not claim that his method of treatment disposes bodily 
of the morbid condition, but that it does measurably assist Nature in her 
efforts to restore the animal to the normal physiological state. It is 
well known that after the beginning of the attack the animal, if left 
to itself, rapidly grows worse until the crisis of the disease is reached, 
at which time death occurs or convalescence begins, usually the former. 
It has been observed, however, that if the treatment is applied within a 
few hours after the inception of the disease its progress is modified in 
such a way that convalescence at once begins, as a rule, and the animal 
hastily recovers its health, usually within twelve hours, although in 
extreme cases it may be as late as forty-eight hours. The following is 
an outline of the plan of treatment of parturient paralysis suggested by 
Schmidt. The operator should disinfect his hands and the udder and 
teats of the cow by washing with a 5 per cent, solution of carbolic 
acid or creolin, or a 1| per cent, solution of lysol or trikresol. The 
apparatus needed for the treatment consists of a small glass funnel, 
a rubber hose three feet long and one-eighth inch in calibre into which 
the funnel fits, and an ordinary milking tube over which the rubber 
hose fits. This apparatus should be sterilised immediately before it 
is used by boiling or soaking in such a solution as recommended for 
washing the udder. Dissolve from 2 to 2j drachms of potassium 
iodide — the size of the dose depending upon the size of the cow 
and the character of the attack — in about one quart of clean water 
previously boiled to sterilise it, and allow the solution to cool to a 



POST-PARTUM PARALYSIS — MILK FEVER — MAMMARY TOX.EMIA, ETC. 465 

little above body temperature, or 40° C. or 104° Falir. The temperature 
may be determined with the clinical thermometer. Withdraw all the 
colostrum or milk from the udder. Then insert the milking tube, with 
hose and funnel attached, into one of the teats, elevate the funnel about 
two feet above the teat and slowly pour in one-fourth of the solution, 
allowing the funnel and hose to become empty several times during the 
process in order to permit the entrance of a liberal quantity of air. 
Eepeat this infusion with the other three quarters of the udder. After 
all is introduced, knead the udder carefully so as to cause the solu- 
tion to permeate the ducts and acini as much as possible. 

As the condition of the cow^ is usually such as to call for addi- 
tional treatment, the veterinarian should not be content with injecting 
the jDotassium iodide solution, but should resort to any and all other 
measures which promise assistance. 

As the cow is usually unable to urinate, the bladder will be found 
filled with urine. This should be removed with the catheter, and its 
removal accomplished at intervals until the recovery of the cow renders 
this procedure no longer needful. 

It may be advisable that catharsis be brought about. As the cow 
is usually unable to swallow, it is dangerous to attempt to give medi- 
cines by the mouth. This may be done if assurance that the cow 
can swallow is obtained. Some have given medicines successfully 
through a probang inserted into the stomach. The plan is feasible. 
Schmidt says that he usually resorted to an aloe powder. If this 
is done 1 ounce to 1^ ounces of aloes may be given. It would seem 
preferable to give the aloes in a bolus, capsule, or drench. Some 
have given linseed oil or Epsom salts. If the animal cannot swal- 
low and a probang is not at hand, one may administer IJ to 2 
grains of physostigmine salicylate subcutaneously, repeating the dose 
in about three hours if purgation is not produced. Eectal injec- 
tions should be given at short intervals in order to get rid of the 
accumulation of hard, dry faeces in the rectum. These injections may 
be of linseed oil, cottonseed oil, or warm soap solution. Schmidt 
recommends, also, enemata of sodium chloride solution. Meanwhile 
the cow should be kept propped up on the sternum by means of bags 
of straw or pieces of wood. If the temperature is below normal, as it 
usually is, the cow should be thickly clothed with blankets and straw 
heaped up about it. Schmidt used powdered digitalis given by the 
mouth when the heart was rapid and weak. It would seem much better 
in every way to give the tincture of digitalis subcutaneously. He has 
also resorted to subcutaneous injections of camphor and caffeine. This 
is good treatment. If the cow does not show marked improvement 
within eight hours the potassium iodide infusion may be repeated. 

D.C H H 



466 NERVOUS SYSTEM. 

Schmidt lias found that as much as 6 drachms may be injected into 
the udder without harm to the cow. Schmidt, in his first report, made 
in 1898, recorded 50 cases treated for parturient paralysis by this 
method with but two deaths from the disease. There were, however, 
only 46 recoveries, as two cows were slaughtered for beef during the 
first day of convalescence. A short time later a report was made by 
Jensen showing that in Denmark up to that time sixty-five veterinarians 
of that country had treated 412 cases by the Schmidt method, 90 per 
cent, of which recovered. Such results seem to indicate this as the treat- 
ment par excellence for parturient paralysis. It still remained to secure 
the introduction of this treatment into the United States and to deter- 
mine what results could be obtained. In all 166 cases were reported ; 
of these 166, 119 resulted in recovery, while 47 were fatal. Of the fatal 
cases, in eight of the cows death may be traced to some complication, such 
as prolapse of the uterus, foreign-body pneumonia, etc. In these cases 
the Schmidt treatment cannot be said to have failed, for it is not in any 
way intended that it shall be able to overcome such accidental conditions. 
If the cow has recovered from its condition of paralysis as a result of 
the Schmidt treatment far enough to be out of danger from that source 
and to i^romise recovery, but later falls a victim to some complication 
that is in no measure a part of parturient paralysis, but only a result 
of that disease, it may with justice be said that the Schmidt treatment 
was a success so far as the malady against which it was directed is con- 
cerned. Looking at the reports from this generous point of view, in 127 
cases out of 166, or 76*5 per cent., the Schmidt treatment was successful 
so far as the parturient paralysis was concerned. 

In a paper published in the Berliner Thierarztliclie Wochenschrift 
in August, 1902, Schmidt reviews the results of his treatment as 
evinced by 914 patients treated by thirty-one difierent practitioners : 
884, or 96*7 per cent., recovered, twelve died and six were slaughtered 
during the course of the disease. Twelve others were slaughtered at a 
later period in consequence of complications. Jensen reported the 
results of 1,744 cases. 

Schmidt also found that the simple injection of air was in many 
cases sufficient to produce recovery, and subsequent observation tends 
to show that the fluid injected is of less importance than was first 
anticipated. A large number of unirritating solutions may be employed. 
Schmidt, however, still counsels the use of a quart of 1 per cent, 
solution of iodide of potassium, in which can be dissolved 5 grammes 
of caffein sodio-salicylate if the heart's action is weak. About 10 
ounces of this solution are injected into each quarter, and are followed 
by a liberal injection of air. The parts should afterwards be freely 
massaged. 



CCENUROSIS (GID, STURDY, TURN-SICK). 467 

CCENUROSIS (GID, STURDY, TURN-SICK). 

Coenurosis is a disease due to invasion of the animal body by em- 
bryos of larvae of the Tcenia ccicnurus of dogs and wolves. These embryos 
only develop freely in the brain substance (Coenurus cevehralis) and 
medulla oblongata. The hosts of the larvae include the calf, sheep, goat, 
roedeer, reindeer and horse. 

The disease was formerly erroneously called '' turn-sick," for the 
turning is only a manifestation, and even a tardy manifestation, of 
the disease, while in addition it is not invariably present. 

Coenurosis principally attacks lambs of from three to six months, 
although it occurs up to eighteen months, and sometimes even two 
years. It is exceptional, however, in adults. Similarly in the bovine 
species it usually affects young animals up to the fourth or fifth year. 

Coenurosis with diffuse parasitic encephalitis often remains unrecog- 
nised, the animals being regarded as affected with epizootic meningitis 
of unknown cause or septic intoxication, and when they die the owners 
are ignorant as to the cause of death. The stage corresponding to turn- 
sick, which is an advanced phase of the disease, is only seen in animals 
which have been infested to a slight extent, and in which three or four 
parasities only, sometimes only one, have attained the brain and de- 
veloped there. Such cases exhibit all the classic symptoms of turn- 
sick, viz., turning movements, heaviness, vertigo, etc. 

Causation. Coenurosis is due solely to one cause, viz., the inges- 
tion of eggs or embryos in feeding or drinking. 

The Tcenia coenurus lives in the dog, and fertilised segments are 
passed with the faeces in yards, pastures and fields, and on the margins 
of roads, ditches and ponds. Amongst damp grass or in water the eggs, 
which contain more or less well-developed embryos, may retain their 
vitality for several weeks, and when swallowed the embryos are set 
at liberty in the intestine. 

The six-hooked embryos perforate the walls of the intestine, pass 
into the blood stream or chyle ducts, and from these points are carried 
in all directions. Tliose which gain the nervous centres, the brain or 
spinal cord, continue to develop ; the others, dispersed through diffe- 
rent tissues, degenerate and disappear. 

Experimental infection with these parasites shows that the brain is 
invaded after about a week's time. From the twentieth day the presence 
of embryos can easily be detected in the superficial layers of the convo- 
lutions. They make their way through tbe grey substance, leaving 
behind them greenish-yellow sinuous tracts with caseous contents. 

The cyst or finn undergoing development can be found at the end of 
one of these tracts in the form of a little transparent bladder, of a size 

H H 2 



NERVOUS SYSTEM. 



varying between that of a pin's head and that of a lentil or a small 
hazel-nut. 

Later the tracts, with their caseons contents, disappear, and the 
development of many of the vesicles proves abortive. At the end of 
a month the vesicles, continuing to develop regularly, attain to about 
the size of a pea. Between the fiftieth and sixtieth days heads or 
scolices appear in the interior of the vesicle, which then reaches the 




Fig. 214. — Brain of sheep, Coenurosis of the left hemisphere. 
(Estrus larvae exposed by trepanation. • 

dimensions of a hazel-nut. From this time the vesicles continue to 
increase in size until the death of the patient. Usually they become as 
large as a walnut, or even larger, and the interior contains hundreds 
of scolices, each showing a head. 

The cystic phase only develops completely in animals whose brains 
contain a limited number of cysts, and in such the signs of turn-sick 
are well developed. In others, where the numbers are large (ten to 
fifteen embryos or more), death occurs during the primary stage, usually 
towards the end of the first month, in consequence of acute encepha- 
litis and wdthout any of the symptoms of turn-sick. 

The number of animals attacked is sometimes enormous. Moussu 



CCENUROSIS (GID, STURDY, TURN -SICK). 



469 



has recorded cases where fifty, one hundred, and even four hundred 
lambs of one flock ^Yere affected. The enormous mortality in such cases 
is very apt to cause errors in diagnosis. Coenurosis occurs most fre- 
quently during rainy seasons, moisture favouring the preservation of 



'^ 




Fig. 215. — Skull of a sheep showing the brain infested with a gid bladder - 
worm {Coenurus cerebralis). Two-thirds natural size. 



the eggs. Young animals become infected, particularly during the 
spring and autumn, more rarely in the summer, as prolonged desicca- 
tion, say for a period of twelve to fifteen days, destroys the vitality 
of the eggs, but animals may become infested at any time through 
drinking contaminated water. Moussu has seen coenurosis (acute 
encephalitis) from the last-named cause in the middle of January. 



470 



NERVOUS SYSTEM. 



Symptoms. First ^^hsise.—Disseviinated encejyhaUtis.—The symp- 
toms vary with the phases of evolution of the parasite and of the disease 
which it causes. After the six-hooked embryos have penetrated to the 
brain, the animals affected lose appetite and show a certain degree of 
dulness, which is all the more marked inasmuch as the animals usually 
affected are young, and therefore should appear bright and alert. Then 
follow wasting and depression ; the animals remain stationary for whole 





Fig. 216. — An adult gid tapeworm 
(Tcenia coenurus). Natural size. 
(After Eailliet.) 



Fig. 217. — Sexually mature segment of 
the gid tapeworm {Tcsnia coenurus). 
cjp, Cirrus pouch ; gp, genital pore ; n, 
nerve; ov, ovary; sg, shell gland; t, 
testicles; tc, transverse canal; iit, 
uterus ; v, vagina ; vc, ventral canal ; 
vd, vas deferens ; vg, vitellogene gland. 
X 20. (After Deffke.) 



hours together, the head being carried low or inclined to one side. At 
this stage disturbance in vision and irregularities in movement may 
appear. 

The eyesight is almost always affected, but the symptoms may vary 
widely. In some cases the patients seem to be absolutely blind, and 
strike against any obstacle in their way ; in others the power of vision 
seems to be lost only on one side. All that can be discerned objectively 
is an inequality in the pupils, together with retraction or dilatation, con- 
vergent or divergent strabismus, nystagmus, etc. The humours of the 



CCENUROSIS (GID, STURDY, TURN-SICK). 471 

eye appear infected, but examination with the ophthahnoscope reveals 
lesions of more or less extensive neuro-retinitis. 

The visual disturbance is of central origin. The powers of move- 
ment may be affected in numerous ways, Avhich at times are extremely 
difficult to estimate with accuracy. Sometimes the gait is uncertain, 
inco-ordinated, and hesitant ; at others the animal shows lameness or 
loss of control over a front or hind limb, or over two limbs simul- 
taneously (either the two front or hind limbs or the diagonal limbs), 
or it may be absolutely unable to stand. 

It walks obliquely, or the front or hind limbs collapse; or again, 
it may persistently lie down, a fact which makes the shepherd think it 
is suffering from paralysis. On examination, however, no true indications 
of paralysis can be found ; sensation and motor power are both pre- 
served in a modified form. 

Death is very frequent at this stage of the disease ; the animals 
eat little or nothing, re- 
fuse drink, and die of ex- 
haustion. 

All this general distur- 
bance is of central origin, 
and is due to disseminated 
parasitic encephalitis, but 

up to this point the seat ^ ^_ ^ . , . u • ^ . ^ -^i. 

t , T- • , , Fig. 218. — Brain of a lamb infested with young 

of the disease is not yet gidh\B,dderwoTms[CoenuruscerehraUs). Natural 

clearly apparent. size. (After Leuckart.) 

Second phase. — Turn- 
sick, — The central symptoms are slow of development, and are due 
to the progressive growth of one or two, more rarely three or four, fer- 
tile vesicles. These are the true symptoms of turn-sick, and it is only 
after this phase of the disease has developed that the term becomes 
appropriate. 

Left at liberty, the patient usually walks in a circle towards the right 
or left in an impulsive and irresponsible fashion. Sometimes it describes 
a circle, always of the same size. In other cases, on the contrary, it 
travels along a spiral track, getting further from or nearer to the centre 
as the case may be. The turning movement may become so accentuated 
that the animal appears to revolve as on a pivot, and if it is confined in 
a field or straw-yard its legs become caught in the litter and it falls to 
the ground. 

Attempts have been made under these circumstances to discover the 
exact point of compression, i.e., the point at which the cyst exists, by 
noting the direction of the turning movement. The diagnosis, however 
arrived at in this way is frequently illusory, because it is not uncommon 




472 



NERVOUS SYSTEM. 



to find two or three vesicles, and in any case the most important informa- 
tion in regard to diagnosis is to be derived from the ocular symptoms. 

When only one vesicle exists, the turning movement usually occurs 
towards the side on which it is situated, and the eye of the opposite side 
is affected with amaurosis. 

If the cyst is situated near the olfactory lobes, the animal marches 
with a high- stepping movement and the head drawn back towards the 




Fig. 219. — fciheep's skull, the hind portion thin and perforated, due to the 
presence of gid bladder worms {Coenurus cereb7'alis). (After Dewitz.) 

body. If the cyst is in the cerebellum the animal is incapable of 
moving, because it can no longer co-ordinate its movements. Finally, 
if the cyst develops in the occipital region, animals turn towards the 
wind, with the neck raised and the head extended. 

At the moment when they fall to the ground they sometimes have 
epileptiform convulsions, grind their teeth, and salivate profusely. In 
a severe attack even death may supervene at this point. 

Ccenurosis of the Medulla. The embryos may develop in the 
medulla oblongata as w^ell as on the brain itself. Compression and 
atrophy of the medulla then give rise to true paralysis. 

The animals exhibit paralysis of the hind quarters, unilateral paralysis 



CCENUROSIS (GID, STUKDY, TURN-SICK). 



473 



only, or still less marked signs. Everything depends on the degree of 
development of the cysts. 

Bovine Animals. Coenurosis in oxen is less important than in sheep. 
Moreover, it very rarely affects a large number of yomig animals belonging 
to one farm. Loss of appetite, dulness and depression are the earliest 
indications, as in sheep. The gaze seems fixed, the neck is held stiffly 
and almost rigidly, the animal shows a tendency to vertigo, pushes its 
head against a wall, or leans the head or neck on the manger or trough. 

Inequality in the size of the pupils, amaurosis, hesitating and inco- 
ordinated movements may also be seen developed in different degrees. 
The a^nimals have the appearance of horses suffering from " InDiwhilite " — 
that is, the very peculiar general condition produced by dropsy of the brain 
ventricles, or from encephalitis. They forget to eat or do not attempt 
to chew unless handfuls of food are thrust 
between the molars ; they plunge the muzzle 
into a bucketful of water and do not drink, 
etc. They take little notice of what passes 
around them, although they may become 
greatly excited if an attempt is made to move 
them, to give them medicine from a bottle, or 
to set them at liberty, etc. Such attacks of 
excitement often end in vertigo and in the 
animals falling to the ground and showing 
epileptiform movements. All these symp- 
toms may occur with extraordinary variations, 
due in reality to the peculiar position which 
the coenurus occupies. 

Second phase. If set at liberty during the first phase of the disease, 
the animal's gait appears only slightly disordered, but when a single 
vesicle has become well developed in one of the hemispheres (and this is 
usually the case with oxen), the symptoms of turn-sick appear as in 
sheep, and are equally varied. The patients seem impelled to move in 
a given direction, whatever obstacles may be in their way. It is not 
at all uncommon to see them thrusting their heads against walls or 
trees, falling into ponds or ditches, or attempting to force their way 
through blind alleys between hay or straw^ stacks. 

After the cyst develops in the cerebellum, the animals are soon 
unable to move. They may be able to stand in one position, but on 
any attempt to move they fall. 

Lesions. The lesions develop successively from the moment the em- 
bryos arrive in the mass of the brain. At first the six-hooked embryos 
only excite a slight disseminated encephalitis. Their course through the 
brain is marked by short, greyish-green caseous tracts, the thickness of 




Fig. 220.— An isolated gid 
bladderworm {Coenurus 
cerebralis), showing the 
heads. (After Kailliet.) 



474 



NERVOUS SYSTEM. 



a needle, which are readily discoverable in the superficial layers. Later 
these caseous deposits become absorbed, the lesions of disseminated en- 
cephalitis diminish and disappear, while a certain number of vesicles after 
partial development undergo atrophy and disappear. Before long nothing 
remains but local atrophic encephalitis caused by the development of the 
vesicles, and from this time the central symptoms begin to appear. 

Diagnosis. When the turning movement has developed the diagnosis 
is generally easy, but it is more difficult during the first period, when 
encephalitis alone exists; or at least, it is very difficult at this period to 
discover whether the symptoms are attributable to encephalitis, meningo- 
encephalitis, coenurosis, tuberculosis, or to some injury. 

Prognosis. The prognosis is grave, and very few animals recover. 




Fig. 221. — Diagrammatic section of a gid bladderworm {Coenurus cerebralis). 
a, Normal disposition of scolex ; b, c, d, e, diagrammatic drawing to show 
the liomology between cysticercus and coenurus. (After Railhet.) 

Ziirn estimated the cases of recovery in flocks at 2 per cent. In these 
cases the cysts degenerate and disappear. 

Treatment. At the present moment there is no really practical 
curative treatment. 

The best plan appears to be to trephine the skull and remove the 
cyst, provided its exact position can previously be determined. That, 
however, is the great difficulty. Its solution presupposes a perfect 
knowledge of the central nervous system and of the real purport of 
any apparent symptoms. 

On the other hand, in sheep at least, the position of the cyst must 
always remain somewhat uncertain, because there are generally several, 
and the symptoms are of a mixed character. 



'' TREMBLING," OR LUMBAR PRURIGO, IN SHEEP. 475 

The only treatment, therefore, \Yhich would be likely to succeed is 
difficult to carry out, and more difficult in the ox than in the sheep be- 
cause of the great development of the frontal sinuses. 

It has been mentioned that under exceptional circumstances the 
coenurus, if very superficially placed, may cause atrophy of the cranial 
wall in the sheep by the outward pressure it exerts, and that the points 
of least resistance may be detected by the touch. In such cases inter- 
vention is necessary and is greatly facilitated; but they must be extremely 
rare, and Moussu declares he has never seen one. 

Hartenstein has suggested continuous cooling of the cranium by 
irrigation or b}^ applications of ice, the local lowering of temperature 
serving to impede the develojjment of the coenurus. This method 
should be tried in animals of high value, and, if the symptoms have not 
yet become too alarming, recovery is possible. On the other hand, when 
the symptoms indicate the presence of an old- standing cyst, there is 
little chance of success. Moreover, the treatment could not be applied 
where a large number of animals are affected. 

It is much better to send the animals to the butcher if they are 
in good condition. In Scotland, however— particularly in Caithness — 
operation is said to be frequently practised with success. 

Prophylaxis. In well-managed establishments it is easy to avoid 
the appearance of coenurosis. 

The development of this condition being due to the Tcenia coenurus 
of the dog, which passes ripe segments containing eggs with its faeces in 
the pastures, the first indication is to prevent the development of this 
taenia in sheep dogs, sporting dogs and house dogs, and the sole pre- 
caution required is to avoid giving them as food sheeps' heads contain- 
ing the bladder worms. But, as despite these precautions they may 
accidentally contract infection with Tcenia ca'nurus by eating the offal of 
slaughtered animals, it is a wise precaution to administer to all farm 
dogs, twice a year at least, a dose of some taenicide. 

They should be starved and kept in for twenty-four hours, and should 
then receive a full dose of some energetic vermifuge, such as areca nut, 
kamala, kousso, powdered pomegranate root, extract of male fern, etc., 
followed by a purgative. The material passed and the faeces should 
be burned or mixed with quicklime. By these simple precautions the 
losses which formerly proved so heavy may entirely be prevented. 



"TREMBLING,^ OR LUMBAR PRURIGO, IN SHEEP, 

The above term is applied to a disease peculiar to sheep, and 
characterised by neuromuscular disturbance, which always ends fatally 
after a longer or shorter period. 



476 NERVOUS SYSTEM. 

Symptoms. Clinically the disease occurs in two forms, one termed 
the convulsive form, the other the pruriginous form. In the convulsive 
form the patients rapidly lose appetite, soon appear unable to stand, fall 
on their sides, and exhibit spasmodic contractions of certain groups of 
muscles. After a time the clonic contractions may give place to per- 
sistent rigidity. The patients are carried off rapidly in a week or two 
without other important symptoms. This disease appears to exhibit 
certain analogies with louping-ill, but these do not seem to be recog- 
nised in France, where it chiefly occurs. 

In the pruriginous form the beginning of the attack is obscure, and 
only the shepherd is able to note anything unusual. The animals move 
in a jerky way, the hind limbs being lifted at times after the manner of 
a horse suffering from stringhalt. They are excitable, exhibit trembling 
movements when touched, with convulsive movements of the head, and 
present an anxious and vacant appearance. The development of these 
symptoms, w^hich constitute what may be termed the first phase of the 
disease, is sometimes prolonged, and in winter may last from one to two 
months. In summer it rarely lasts longer than a week or two. 

At this stage a special pathognomonic symptom develops, viz., intense 
and permanent pruritus of the hind quarters, w^hich causes the animals 
to rub the croup against any projecting objects, walls, mangers, etc. 
They thrust themselves backward against the object, and rub with 
such violence that the wool is torn away and the skin itself often 
excoriated, although the irritability appears to be in no wise dimin- 
ished thereby. In the fold the animals sometimes rub against one 
another, making their sides raw, and bite themselves on the croup, 
the quarters, and the tail. 

When the affected parts are touched with the hand, peculiar move- 
ments of the head and the lips are immediately excited, similar in 
character to those caused by mange. Up to this time the animals 
continue to feed, but they progressively lose condition, become weak 
in the hind quarters, and fail to keep up with the other animals in 
the flock. Their gait becomes hesitating; they move with a trotting 
step and appear semi-ataxic. 

All these symptoms develop without fever, but become aggravated 
from day to day, until they end in paraplegia and death. This second 
phase lasts for a period of from two to four months in winter. 

Lesions. No lesions can be detected on a simple examination of the 
dead bodies. Gilbert has mentioned a change in the blood ; Trasbot, 
chronic inflammation of the pia mater and of the lumbo- sacral portion of 
the spinal cord. German writers have described sclerotic changes in the 
posterior portions of the cord. Moussu has carried out a large number 
of examinations, but has never found these lesions, either on anatomical 



"TREMBLING," OR LUMBAR PRURIGO, IN SHEEP. 477 

or on histological investigation, and he considers that they are not by 
any means present in all cases. 

Besnoit and Morel, who carried out a very remarkable anatomical 
and pathological study of the disease, used Nissl's staining method, but 
only found very discrete changes in the cord (vacuoles in the motor cells 
of the anterior horns). They found, however, significant lesions of 
neuritis in the peripheral nerves. 

Causation. The cause is as yet little understood, and it is difficult 
to prove how the forms of neuritis described by Besnoit are brought 
about. 

The disease was not known in France before the introduction of 
Merinos, and former investigators referred it to heredity, consanguinity, 
precocity, and even to sexual excitement. German writers declare that 
it seems more particularly to attack rams and the better-bred varieties. 
In reality, the disease occurs in all flocks, and in all kinds of sheep 
indiscriminately ; it attacks ewe lambs and young castrated lambs 
as well as rams. Moussu is absolutely of this opinion, and for w^ant 
of more precise information agrees with Trasbot, and, he believes, with 
Besnoit, that the symptoms shown may possibly be referred to a 
chronic intoxication. 

Diagnosis. The diagnosis is difficult during the early stages, but 
when the pruritus becomes manifest there can no longer be room for 
doubt. 

Cases of paraplegia might perhaps be mistaken for paraplegia due 
to coenurosis, but in the latter case there is no pruritus. 

Prognosis. The prognosis is extremely grave, observation having 
shown that all the patients die after a longer or shorter time. 

Treatment. Until now treatment has proved absolutely useless, and 
it would seem the best course to slaughter the animals before wasting 
becomes marked. 



SECTION VI. 

DISEASES OF THE PERITONEUM AND 
ABDOMINAL CAVITY. 

CHAPTER I. 

PERITONITIS* 

Peritonitis, i.e., inflammation of the peritoneum, may attack any of 
the domesticated animals. It must, however, be regarded as an almost 
accidental and relatively infrequent disease. It is due to infection of 
very varying character, and from the clinical standpoint may assume 
one of two forms — acute peritonitis or chronic peritonitis. 

ACUTE PERITONITIS. 

The micro-organisms which produce peritonitis have not been the 
subject of special investigation in the domesticated animals, though 
the colon bacillus and streptococci, so frequently found in the female 
genital tract after parturition, seem to be the most frequent causa- 
tive agents. Certain putrefactive organisms may also bring about the 
disease. 

The peritoneum may become infected, and acute peritonitis ensue 
under various circumstances. 

All operations in which the peritoneal cavity is opened, such as 
castration of the cow and of the sow, laparotomy, gastrotomy, enter- 
otomy, etc., may be followed by acute peritonitis if performed without 
sufficient regard to aseptic precautions. Peritonitis then usually 
assumes an acute septic form. 

Even simple puncture of the rumen, though usually quite harmless 
if carefully performed, may by followed by local or general peritonitis 
should food material escape from the rumen and find its way into the 
peritoneal cavity. 

One of the most frequent causes is infection from the genital tract 
soon after parturition. Here the agents of infection are not introduced 
directly into the cavity, but find their way there in consequence of a 



ACUTE PERITONITIS. 479 

diseased condition of the mucous membrane and the uterine walls. 
Ascending infections of this character and infections by contiguity of 
tissue may only give rise to local peritonitis, though in too many 
instances they become generalised. 

Acute peritonitis may follow infection from the stomach or bowel, 
should a foreign body perforate the rumen or reticulum and pass 
backwards towards the peritoneal cavity, or a serious intestinal inflam- 
mation (enteritis, invagination, etc.) facilitate the passage of microbes 
through the thickness of the intestinal wall. 

Abscess of the liver, suppurative echinococcosis, renal infection, 
pyelo-nejDhritis, acute cystitis, rupture of the bladder, etc., may in a 
similar way become complicated with acute peritonitis. 

Finally, abdominal wounds may cause interstitial ruptures and 
lesions in the serous membrane, accompanied by local exudation 
(kicks, horn-thrusts, blows from cart-poles, etc.), and if microbic 
agents are brought within the region of the lesion by the general 
circulation or otherwise, peritonitis may follow. 

Symptoms. At first the symptoms are vague and imperfectly 
defined, and diagnosis is always very difficult during the first few 
days, except in cases where there exists a lesion or a condition pre- 
viously recognised as likely to become complicated with peritonitis. 

The early symptoms comprise fever, loss of appetite, arrest of 
rumination, rigors, constipation, etc., but these symptoms only at- 
tain full significance when accompanied by what has been termed 
"peritonism." 

The patient appears to be suffering from tympanites, as may really 
be the case, but the tympanites of the rumen and gaseous distension 
of the loops of bowel are not primary, and only result from the arrest 
of peristalsis. The primary condition is peritonism, i.e., distension of 
the peritoneal cavity, this being indicated by a symmetrical fulness 
of the right and left flanks. 

The patients suffer from dull colic, and from this time always 
assume an attitude indicating pain. They remain in one position, 
with the back arched, the limbs gathered together, and the lower 
abdominal wall shortened. The face expresses suffering, the respira- 
tion is short and rapid .and of the costal type, movement is painful 
and causes groaning, and the animals do not shrink when the lumbar 
region is pressed upon. 

Palpation of the abdomen causes pain, and if practised at certain 
points may be followed by groaning. This method of examination, 
however, gives no further information, because the abdominal wall 
is rigid, tense, and as though tonically contracted. 

Percussion is followed by tympanic resonance in the right and lef-t 



480 PERITONITIS. 

upper zones, due to accumulation of gases of fermentation, and to 
distension of the peritoneal cavity itself. Towards the lower parts, 
however, percussion produces a dull sound. The presence of liquid 
can here be detected by the manner in which impulses are trans- 
mitted, particularly at the period of crisis and when much exudation 
exists. 

Abdominal auscultation shows that the digestive movements are 
arrested. Peristaltic movement ceases, and the movements peculiar 
to the rumen and to the progress of food through the intestine are 
absent. Fermentation sounds, however, can be detected. 

The heart beats are strong, rapid and violent, and yet the pulse 
remains feeble, though the artery is tense. 

At a later stage, when the disease becomes aggravated, pain is 
less acute, depression is extreme, the animals no longer even drink, 
the abdominal wall becomes relaxed, and diarrhoea is succeeded by 
constipation. Palpation of the abdomen is less painful and does not 
cause groaning, but the pulse becomes feebler, much more frequent, 
imperceptible, and at last the animal dies from intoxication and 
exhaustion, caused by the fever and pain. 

When peritonitis is due to rupture of the intestine or escape of 
alimentary material from the rumen into the peritoneal cavity, as 
may occur after puncture of the rumen or gastrotomy, etc., fever 
IS not always very marked. The temperature may even fall below 
the normal point. Some cases vary greatly from the type described 
as regards their development, but the important features are always 
present, and the difference is chiefly found in the course of the disease. 

Diagnosis. The diagnosis is rather difficult, but when there is 
colic, together with persistent peritonism, exaggerated sensitiveness 
to palpation and arrest of the functions of the digestive apparatus, 
there is little room for doubt. 

Prognosis. The prognosis of acute peritonitis is very grave. 

Lesions. The lesions vary with the primary cause (traumatism, 
metritis, suppurative echinococcosis, foreign bodies escaping from the 
digestive tract into the peritoneal cavity, etc.). 

The parietal and visceral layers of the serous membrane are always 
inflamed, vascular, roughened, dull, and in places covered by vege- 
tations. Between the loops of intestine and in the peritoneal pockets 
there are discovered more or less numerous and more or less thickened 
false membranes, presenting the characteristics of the false membranes 
seen in acute pleurisy. 

The liquid varies in quantity and in colour, being sometimes lemon- 
yellow, sometimes purulent, sanguinolent, or even blackish, and of 
putrid odour. 



CHRONIC PERITONITIS. 481 

The lesions may appear more marked at a particular point, such as 
the uterus, rumen, hypochondrium, etc., and the intestinal loops may 
become partly fixed in position by false membranes. In time these false 
membranes may solidify arid undergo transformation into fibrous tissue. 
Treatment. Treatment is generally useless in cases where perito- 
nitis results from rupture of the bladder or intestine or from eventra- 
tion. Complete and perfect cleansing of the infected abdominal cavity 
is impossible in large animals. 

In other cases the animals should be left completely at rest, and 
purgatives should be avoided. Movement or the administration of pur- 
gatives provokes peristalsis, and, as a consequence, almost inevitably 
leads to generalisation of a lesion which might otherwise have some 
chance of remaining localised, as in pelvi- peritonitis and peritonitis due 
to foreign bodies issuing from the rumen or reticulum. If the move- 
ments of the intestinal loops disperse the septic liquids beyond the 
points originally injured, the whole cavity becomes inoculated and 
generalised peritonitis is set up. 

Emollient and diuretic drinks containing opium, and oatmeal or 
linseed gruels, have the advantage of soothing the colic and preventing 
stagnation in the bowel. These should be given from the first and solid 
food entirely avoided. 

The sides of the abdomen should be mildly stimulated, provided the 
operation does not give rise to undue pain and cause the animals to 
struggle. Vesicants are preferable to mustard, though mixtures of 
mustard and linseed meal may be used, and, if found advantageous, 
can be repeated. 

Mercurial salts, though much used in earlier times, are now entirely 
given up. Diuretics, such as bicarbonate of potash, nitrate of potash, 
alcohol, and acetate of ammonia, should be used, according to cir- 
cumstances. 

Aseptic washing-out of the peritoneal cavity would be advantageous, 
but in large animals cannot easily be effected. 



CHRONIC PERITONITIS. 

Causation. Chronic peritonitis may occur as a termination of the 
acute form, but it may also develop gradually as a result of disease of 
the kidney (p}' elo-nephritis) , of the uterus or ovaries (chronic metritis, 
tumour of the ovary), of the liver (suppurative echinococcosis), or of 
any other lesion in neighbouring parts which is capable of setting up 
continued irritation. 

It also accompanies tuberculosis of the peritoneum, cancer of the 
peritoneum, chronic disease of the bladder, etc. Further, it appears, 

D.C. I I 



482 PERITONITIS. 

but more rarely, in certain chronic diseases, such as chronic dysentery 
and lymphadenitis. 

Lesions. The lesions consist of local thickenings of the peritoneal 
layers, and nmnerous papilliform vegetations scattered very irregularly 
over the parietal peritoneum, mesentery, epiploon, etc. 

If the disease has existed for a long time, fibrous bands or solid 
adhesions may be discovered, connecting various parts of the digestive 
apparatus \^'ith one another, or with the abdominal walls. 

Sometimes the intestinal contents seem almost entirely adherent to 
the abdominal walls. 

The primary lesions of the liver, spleen, kidneys, or genital organs, 
from which the disease originated, are also found. 

The quantity of exuded liquid varies greatly ; sometimes there is a 
great quantity of a transparent or lemon-coloured liquid, resembling that 
of ascites. In other cases the liquid is scanty, and may be confined 
between layers of bowel, which are connected by an inflamed layer of 
epiploon. 

These old-standing lesions cause atrophy of the abdominal organs, 
contraction of the intestine, and sometimes true obstruction. 

In chronic tuberculous peritonitis the adhesions between the intes- 
tine and the abdominal walls may be enormous. The peritoneum is 
generally covered with great masses of tuberculous new growth, while 
the mesenteric and sublumbar lymphatic glands are attacked. 

Symptoms. The disease develops without marked fever or grave 
interference with the chief functions, and the first approach of the 
disease may, therefore, easily be overlooked. Chronic peritonitis, 
moreover, may remain strictly localised. 

When the disease assumes the ascitic form the dominant sign is 
readily detected. Where new membranes form the principal lesions the 
symptoms are much less definite, and the existence of disease is chiefly 
indicated by digestive disturbance, such as diminished peristalsis, the 
occurrence of colic, diarrhoea, etc. 

It is well to remember, however, that these troubles often follow an 
ascitic stage, w^hich may gradually disappear owing to the fluid becoming 
absorbed. Even in the fibrous form, where the intestines appear com- 
pletely glued together by adhesions, the volume of the abdomen is 
increased and the belly is deformed, as in ascites. 

In time patients suffering from primary lesions of an important 
internal organ are aft'ected in their digestion, lose flesh and become 
anaemic, and finally cachectic. 

Diagnosis. The diagnosis is by no means easy, particularly in the 
fibrous forms, owing to the great difficulty of discovering the primary 
lesion. 



ASCITES. 483 

Prognosis. The prognosis is grave, though it must not be regarded 
as necessarily fatal. In cases resulting from genital diseases, and in 
localised chronic peritonitis resulting from persistent, but not excessive, 
mechanical violence, complete and perfect recovery may occur. 

On the other hand, in cases of chronic lesions of the liver, kidneys, 
heart, etc., and in tuberculosis, carcinoma, etc., recovery cannot be 
expected. 

Treatment. Treatment should be directed towards combatting the 
chronic inflammation. With this object resort may be had, when neces- 
sary, to persistent stimulation of the sides of the abdomen, mild blisters 
and mustard plasters, or friction with turpentine. 

The food should be easy of digestion, and of first-rate quality. The 
most useful drugs comprise mild, unirritating diuretics, general stimu- 
lants, and tonics. 

Animals affected with incurable lesions should not be treated. 



ASCITES, 

True ascites consists in dropsy of the peritoneum, unaccompanied by 
inflammation of that membrane, or by the presence of infectious micro- 
organisms'in the transuded liquid. Properly speaking, it is not a morbid 
entity, but only a symptom common to several very complex diseases. 

Causation. The diseases which produce it may be set forth under 
five principal heads : — 

(1.) Cardiac affections in general, particularly chronic lesions of the 
heart, interfering with venous circulation, and causing prolonged stasis 
of blood in an organ or tissue. 

(2.) Pericarditis due to foreign bodies, and the various forms of 
pseudo-pericarditis, i.e., lesions in the neighbourhood of the heart, 
causing compression of that organ and of its vessels. 

(3.) Generally speaking, all lesions which interfere with the return 
circulation, particularly lesions of the liver (distomatosis, echinococcosis, 
and interstitial hepatitis). These produce compression of the portal 
vein or other obstacle to circulation, and the transudation is exclusively 
localised in the abdominal cavity. The connective tissue does not 
become infiltrated. 

(4.) Diseases of the kidneys (nephritis, pyelo-nephritis), which 
secondarily produce cardiac disturbance. 

(5.) Gestation, which causes compression of certain digestive viscera, 
and of certain veins of the pelvic cavity. 

Ascites was formerly regarded as always forming a complication 
either of anaemia or of hydrsemia. We now know that the primary 
cause of these three collections of symptoms (ascites, anaemia, and 

II 2 



484 PERTTONITIS. 

hydraemia) is the development of certain chronic wasting diseases or 
chronic lesions of the heart, liver, and kidney, which act and react upon 
each other. 

Symptoms. True ascites is unaccompanied by fever. The condition 
develops slowly, insidiously, and therefore escapes notice at first. Only 
when the exuded liquid is present in considerable quantities is the 
condition apparent. The symptoms are similar to those of ascites 
following chronic peritonitis. 

The transuded liquid progressively accumulates in the peritoneal 
cavity, the lower portion of which it distends. When the animal is 
viewed from behind the enlargement appears symmetrical, despite the 
position of the rumen. The intestinal contents float on the liquid and 
are thrust upwards towards the lumbar region. On palpation, the ab- 
dominal cavity seems unusually full, the tension differing in proportion 
to the quantity of liquid. The accumulation of liquid may become con- 
siderable and interfere with respiration, circulation, and movement. 
Yery marked anaemia always exists, the mucous membranes are ex- 
tremely pale, the respiration is rapid, the pulse feeble, all these 
symptoms being consequent on the primary disease of the heart or 
liver. Percussion of the lower part of the belly jjroduces a dull sound. 
On the left side this dulness often extends from the linea alba as high 
as a horizontal line, uniting the external angle of the ilium and the 
hypochondriac circle. On the right it is bounded by a horizontal line. 
Percussion or, better still, palpation provokes on one side of the abdomen 
a wave or impulse of the liquid, perceptible to the touch or even to 
the view at the opposite side. 

Diagnosis. In general diagnosis is easy, thanks to the slowness 
with which the disease develops. 

Prognosis. The prognosis varies in each case, more especially 
according to the more or less marked debility of the animal. Ascites due 
to gestation is usually of a very simple character, but if it is the result 
of pericarditis produced by a foreign body, or of nephritis, the outlook is 
very gloomy ; lesions of the kidney in particular showing little tendency 
to recovery. Finally, the prognosis varies when the ascites follows 
disease of the liver, for certain exceptional cases have been noted in 
which an attack of hepatitis has led to the disappearance of the 
transudate. 

Lesions. The lesions peculiar to this disease are very trifling. 
Transudation takes place without inflammation of the peritoneum, 
although the veins of the abdominal cavity are abnormally dilated. 
The abdominal wall is thin and distended, and the tissues are colour- 
less as though soaked in water. The cavity is distended with a clear 
lemon-coloured albuminous liquid free from blood corpuscles. 



PERITONEAL CYSTICERCOSIS. 485 

Treatment. The treatment must vary according to circumstances, 
i.e., having regard to the primary cause. Ascites due to gestation, 
which is always sHght, calls only for simple hygienic treatment ; but 
when the disease is attributable to lesions of the heart, pericarditis, or 
chronic affections of the kidney or liver, it is generally incurable in 
common with the original lesions themselves. 

If, finally, no clearly defined cause can be detected, or if the ascites 
is due to chronic peritonitis, treatment shoald be attempted. The first 
stei3 may consist in evacuation of the liquid for the purpose of reducing 
the excessive pressure on the diaphragm and facilitating respiration. 
For this purpose an aseptic puncture is made with a fine trocar on the 
right side of the abdomen in the flank region, about equidistant from 
the umbilicus and the loose flap of skin in front of the stifle. The ab- 
sorption of liquid may afterwards be assisted by administering diuretics, 
such as digitalis, bicarbonate of potash or nitrate of potash, and by 
giving lukewarm drinks, tonics, etc. In Germany injections of pilo- 
carpine have been suggested, but it is doubtful whether they have 
proved satisfactory. 

PERITONEAL CYSTICERCOSIS. 

The above name has been given to a parasitic disease caused by the 
infestation of young animals, such as calves, lambs and young pigs, with 
embryos of the Tcenia marginata of the dog. 

Symptoms. Peritoneal cysticercosis is often of so mild a character, 
and the number of embryos which penetrate the body so small, that in 
the majority of cases there are no visible symptoms. It is not until the 
meat comes to be dressed by the butcher that little cysts (Ci/sticercus 
tennicoUis are discovered in the abdominal cavity. 

Unfortunately, in excejDtional cases it may also happen that the 
number of embrj^os in the abdominal cavity is so great as to produce 
lesions of acute hepatitis, acute peritonitis, and sometimes pleurisy. 
These grave forms are more common in young pigs and lambs. 

The animals appear dull, feeble, exhausted and without appetite, 
but exhibit marked thirst, lose flesh and become anaemic in a few 
days. Soon afterwards they show symptoms of acute peritonitis, 
with exudation of fluid, and death may follow in a week or two. 

In cases where infestation is less marked, the animals may exhibit 
only progressive anaemia, without well-developed symptoms of peri- 
tonitis, until death occurs. 

Lesions. On post-mortem examination a sero-sanguinolent exuda- 
tion is seen, together with more or less numerous false membranes, and 
a varying number of young cysticerci floating freely in the liquid or en- 
closed in the folds of the mesentery. The cystic vesicles are spherical. 



486 PERITONITIS. 

ovoid, or elongated, and translucid or opalescent. They are some 
millimetres in diameter, and in some cases are very numerous, ranging 
from a few hundreds up to sevei'al thousands, but in others compara- 
tively few. 

The liver shows signs of intense hepatitis, caused by embryos 
burrowing into its tissue. 

Causation. The causes are limited to a single fact, viz., ingestion 
of the eggs of Tcenia marginata, which are spread over the fields in 
the excrement of dogs suffering from that parasite. 

Diagnosis. The diagnosis can only be arrived at by a post-mortem 
examination, when cysticerci in various stages of development are 
discovered. 

Prognosis. The prognosis is difficult to indicate, because every- 
thing depends on the intensity of the infestation. 

Treatment. No curative treatment is possible, direct action on 
the developing parasites being impracticable. Nevertheless, some 
patients survive, and after having shown grave general disturbance 
may gradually improve. 

The only efficacious treatment is of a prophylactic nature, as in 
ccenurosis and echinococcosis. Dogs suffering from taeniae should 
periodically be treated and freed from their parasites. 



CHAPTER II. 
HERNI^.^ 

CONGENITAL HERNI/E, 

PERINEAL HERNIA OF YOUNG PIGS. 

This variety is very common in young pigs, on account of their 
anatomical peculiarities and of the persistence and enlargement of the 
inguinal canal. Loops of intestine, impelled by their own weight, 
accumulate at the lowest point and readily pass into the canal. 

It is usually when the little pig begins to eat, i.e., a fortnight or 
three weeks after birth, that the symptoms become plainly apparent. 

The hernia is indicated by a swelling which commences in front of 
the pubis and extends backwards behind the hind limbs. When the 
herniated loop of intestine is examined by palpation, the presence 
of liquid in it can be detected, particularly after a meal, while a 
characteristic gurgling sound is heard. 

Diagnosis. To confirm the diagnosis, the animal is placed on its 
back, whereupon reduction as a rule is easily effected. As soon as the 
animal rises again the hernia returns. 

The prognosis is not grave. 

The treatment is exclusively surgical, and the hernia can be reduced 
and castration performed at one and the same time. The animal being 
placed on its back and firmly held, an incision of about 2 to 3 inches 
in length is made in the inguinal region, dividing the skin and sub- 
cutaneous connective tissue only. The vaginal sheath is then com- 
pletely isolated, the hernia reduced, and a ligature applied to the 
sheath and the spermatic cord close to the abdominal wall. The 
testicle is then removed. 

If adhesions have been set up, which is quite exceptional, the vaginal 
sheath is incised and the loop of adherent intestine liberated, when it 
can readily be returned. The vaginal sheath and spermatic cord are 
then twisted as high as the level of the inguinal ring and tied with 
catgut. To prevent this ligature becoming displaced, it should be fixed 

■^" For a fuller description of herniae and their treatment, see Moller and Dollar's 
"Regional Surgery," pp. 263 — 309. 



488 HERNIA. 

by passing a sterilised thread through it and through the mass of 
tissue ; the hernial sac should be divided immediately below. In order 
to ensure greater security, it may even be desirable to pass a suture 
through the margins of the inguinal ring. 

Umbilical Heenia. 

Umbilical hernia is less common in young animals of the bovine, 
ovine and porcine species than in the foal, and when existing almost 
always disappears at the period of weaning. The rumen then assumes 
its full development, the loops of intestine are displaced and thrust 
towards the sublumbar region, and the hernia disappears. The same 
is true of the young pig, the development of the stomach producing 
the same favourable result. 

In the rare cases where this hernia is not reduced spontaneously, it 
may be necessary to utilise the methods so frequently employed in the 
foal, and, despite the number of these, there are only two which can 
thoroughly be relied on to give good results. 

In the first, irritants are employed. 

Subcutaneous injections of concentrated solution of common salt, 
filtered and sterilised, or 10 per cent, solution of chloride of zinc pro- 
duce enormous engorgement of the connective tissue, which thrusts 
back the herniated loop of intestine and later causes the development 
of very resistant fibrous tissue, which prevents the hernia returning. 

To ensure this result, however, it is indispensable that perfect 
asepsis should be observed in the injections, for if germs are intro- 
duced severe suppuration occurs at the point of injection. The 
injections are made at four opposite spots in the subcutaneous tissue 
surrounding the hernia, 1 to 2 drachms of saline solution being 
injected at each spot ; of the chloride of zinc solution half a cubic 
centimetre is used. This method is only of value in small hernias, 
which may sometimes be cured by the application of sinapisms alone. 

The second method is applicable to larger hernise, and aims at 
destroying the hernial sac. 

The application of clams is simplest, and can be recommended. 
The patient is placed on its back, reduction is effected, the hernial sac 
is drawn upwards vertically, and the clams placed as near the 
abdominal wall as possible, after care has been taken that no portion 
of the intestine is included in the sac. The clams are kept in place 
by a suture passed through the neighbouring tissues. 

In other cases where a radical cure is necessary, because of adhesions 
within the hernial sac, the patients are similarly placed on their backs, 
the hernial sac is opened aseptically, the adherent parts liberated, the 
herniated portions of intestine reduced, and the hernial ring sutured 



ACQUIRED HERNIA. 



489 




with sterilised strong silk, the skin being afterwards brought together 
with silk sutures after removal of the sac itself. A surgical dressing 
can then be applied to the umbilicus. The patients should be carefully 
dieted. 

When the hernial ring is large and its lips widely dilated, the silk 
sutures, even when supported by secondary sutures, sometimes cut- 
through the tissues and do not 
achieve the desired result. 

Degive's method (see "Moller 
and Dollar's Kegional Surgery," 
p. 304) can then be employed. The 
hernial sac is opened under anti- 
septic precautions, in order to break 
down any existing adhesions, and 
the skin and edges of the hernial 
ring are transfixed with packing 
needles about 8 inches long. Above 
these is adjusted a clam, which is 
closed, by means of a screw and 
firmly secured. The packing needles 
are then replaced with horse-shoe 
nails, the points of which are bent 
round. In about a week the ne- 
crotic tissue falls away, and recovery 
occurs even in severe cases in which 
previous treatment had failed. 



Fig. 2. 




Fig.3. 




ACQUIRED HERNI/E. 



Fig. 222. — Schema illustrating Degive's 
operation for umbilical and ventral 
herniae. A, Serous ; B, musculo- 
aponeurotic, and C, cutaneous coats 
of the hernia; D, the special needle 
in place ; EE, clams ; FF, nails. The 
three figures show the successive 
stages of the operation. 



Acquired or accidental hernise 
are not serious, and only deserve 
to be studied in so far as they 
affect organs contained within the 

abdominal cavity. They may result from violence, or may occur 
without the intervention of any external cause. 

Traumatic hernise may occur at any point in the abdominal wall. 
Under the influence of a violent blow from a waggon pole, a horn 
thrust, a kick, a fall, etc., the muscular tunic of the abdominal wall 
is injured and becomes fissured in the direction of its fibres. The 
peritoneum is rarely affected. Being pushed outwards by the digestive 
viscera, however, the peritoneum projects into the muscular layer, 
distends it, separates the layers of subcutaneous tissue, and finally 
forms a distinct hernia. 



490 HERNIA. 

The consequent disturbances are more or less marked and the 
lesions more or less variable, according to the part affected. In the 
lower region fissure of the abdominal wall affects the rectus abdo- 
minis, obliquus abdominis and transversus abdominis, and on the right 
side gives rise to hernia of the abomasum or small intestine, on the 
left of the rumen. In the lateral regions muscular fissures can be 
produced only in the transversus and obliquus abdominis muscles. 
Hernia of the rumen is rare on the left side. On the right side hernia 
of the intestine is more readily produced. 

In all cases where hernia is suspected, the hernial orifice should be 
examined. Its situation will at once show which organ is affected. 

Spontaneous hernise are very rare in the domesticated animals. 
They occur only in aged animals, and various reasons have been suggested 
to explain their appearance. Certain hernias of this character are only 
found in old female animals which have borne a considerable number of 
young. Ee^Deated gestation produces elongation and relaxation of the 
muscular fibres from the weight of the foetus and its envelopes. In time, 
the abdominal walls become thinner and thinner under the weight of 
the viscera, and thus facilitate the slow formation of a hernia. Certain 
practitioners consider that some of these spontaneous hernise are due 
solely to the pressure j)roduced by the distended viscera, as for example 
in greedy-feeding animals. In such cases the weight of the viscera 
would cause, as in the previous case, a certain degree of anaemia and 
emaciation of the abdominal muscles. 

These spontaneous ventral herniae are due in reality to changes in 
the nutrition of the abdominal wall, the exact cause of which it is diffi- 
cult to ascertain. The elastic tunic becomes atrophied, and ceases to act 
as an automatic girth ; the muscular wall gradually becomes sclerosed 
from the wdiite line towards the sides, and having lost its elasticity 
becomes distended and thinned. 

These changes are not exclusively caused by old age, for they may 
be found even in young animals. 

Nothing can be done in cases of spontaneous hernias. The qualities 
originally pertaining to the abdominal wall cannot be restored, and 
treatment is confined to applying suspensory bandages, and, where pos- 
sible, preparing the animals for slaughter. 

HERNIA OF THE RUMEN. 

Causation. Hernia of the rumen is, as a rule, of traumatic origin, 
and always occurs in the left flank, either in the lower or middle regions. 
Cases of spontaneous hernia of the rumen have been observed in very 
old and anaemic animals, as well as in females which have borne many 



HERNIA OF THE RUMEN. 491 

young and which have suffered from spontaneous progressive hernia of 
the uterus. 

Symptoms. The symptoms are the same in all hernise. Imme- 
diately after the injury the abdominal organs show a tendency to escape in 
the direction of least resistance. A fold of the rumen passes through the 
muscular fissure, and a sw^elling soon becomes visible externally, which 
alters the contour of the abdomen. Most frequently at this time traces 
of the injury can be detected on the surface of the skin, either the linear 
trace due to a horn thrust, the ill-defined lesion due to a kick, or what not. 
There foUow^s rapid swelling, which results from the inflammatory re- 
action due to rupture of small vessels within the muscle. A certain amount 
of sanguineous exudation and of oedematous swelling occurs, and may at 
first suggest the existence of an abscess of the abdominal wall. At 
the same time there is more or less fever, which may continue for 
a few days, but the swelling seldom lasts very long ; in two or three 
days even, it becomes reabsorbed, commencing at the upper part and 
diminishing progressively downwards. 

Henceforth the hernia alone remains. 

It is soft, compressible, and sometimes susceptible of reduction. On 
palpation, the operator feels a rupture extending through the tunic and 
the abdominal w^all, sometimes even through the muscular tissue of the 
rumen, in cases where the skin is neither perforated nor torn through. 
The mucous membrane of the rumen is rarely ruptured. 

Whether or not the peritoneum is injured, the rumen presses be- 
tween the lips of the wound, thrusts back the skin, and separates the con- 
nective tissue, thus setting up local irritation and oedematous swelling. 
The rumen may contract more or less close adhesions with the abdo- 
minal wall, and even wdth the subcutaneous tissues. 

Afterwards, w^hen the exudate has been reabsorbed, palpation re- 
veals a different condition of things. The mass is uniformly fluctuating 
or semi-fluctuating, and is surrounded at the base by an indurated ring 
of very varying dimensions. The final indication — which, however, is 
not invariably seen — deserves attention, viz., the change in volume of 
the hernia at different moments, particularly during meals. This 
change in size only occurs if the hernial orifice is large. 

In cases of spontaneous hernia of the rumen, the condition is not 
fully established at first. It is always progressive, and the lesion is 
situated in the lower ab'dominal region. It increases in size from day 
to day, from week to week, whilst the animals lose appetite and flesh. 
Spontaneous hernige are never accompanied either by exudation, en- 
gorgement, fever, or traces of mechanical injury. 

When only slightly developed, hernige do not threaten life, a fact 
which often prevents the owners troubling about them. Progressive 



492 HERNIA. 

hernise may become of considerable size, and two cases are recorded in 
one of which the opening of the hernial sac was 13 J inches in length 
and 18 inches in width, and in the other 28 inches in length and 24 
inches in width. The latter is the largest ever recorded. 

Complications. Complications are not always grave. If the hernia 
is little marked the function of the rumen is not greatly affected and its 
rhythmic contraction continues. When the original injury has caused 
rupture of the muscular tissue of the rumen, and the mucous mem- 
brane has passed into the opening, it may become strangulated and 
gangrenous. 

Finally, if the mucous membrane has been torn at the same time 
as the muscular tissue (which is very uncommon), alimentary material 
may escape into the subcutaneous connective tissue, setting up either 
cellulitis and death by infection, or suppuration ; abscess formation and 
ru]3ture towards the exterior, followed by a persistent sinus ; or again 
septic peritonitis, and death. 

The same results may occur when the hernia is in a very low portion 
of the abdomen ; food accumulates in it, becomes stagnant there, sets up 
local irritation and inflammation, and sometimes abscess formation with 
external discharge, followed by fistula of the rumen. 

Gastric fistula without secondary complications is compatible with 
life, and even with fattening for slaughter, provided the peritoneum 
covering the rumen becomes attached to the opposing surface of peri- 
toneum around the perforation. The fistula is then surrounded by a 
circular mass of fibrous tissue, forming a kind of sleeve. 

Lesions. The lesions are the same in all herniae. They consist 
primarily in rupture of the abdominal wall, and, later, of sero-san- 
guinolent infiltration of the margins of the wound, similar to that ac- 
companying the formation of an abscess. Hernial swellings are of 
very varying size. Apart from cases similar to those above described, 
the swelling may be simply an inch or two in diameter, or it may 
attain the dimensions of a hen's egg or even of a man's fist. 

When the abdominal tunic only has been ruptured, as is most fre- 
quently the case, the peritoneum is thrust outwards and forms a cavity, 
the hernial sac. This sac is absent when the peritoneum is ruptured. 
Little by little the surrounding connective tissue forms a pseudo-serous 
hernial sac. But, nevertheless, in some cases there may be found, im- 
mediately under the skin, the mucous membrane of the rumen in a 
state of congestion and ready to become gangrenous. 

Diagnosis. Easy in all cases. 

Prognosis. Yery variable. In the case of small herniae situated in 
the lateral regions of the abdomen the prognosis is not very grave. If, 
however, the rupture is wide, and situated in the lower portion of the 



HEKNIA OF THE ABOMASUM. 493 

abdominal walls in a dependant position, the hernial swelling steadily 
grows in size in consequence of the weight of the food which is constantly 
thrust in this direction by the contraction of the rest of the rumen, and 
recovery is impossible. The only resource is to fatten the animals as 
quickly as possible for slaughter. 

HERNIA OF THE ABOMASUM. 

Causation. This condition is due to causes similar to those above 
mentioned, including mechanical violence. It is rare in adults, but 
much commoner in young animals, especially in sucking calves, wh-ere 
the abomasum is the most highly developed digestive compartment. 

Hernia of the abomasum is produced essentially and almost ex- 
clusively by horn thrusts inflicted when calves attempt to suck cows 
other than their own mothers. 

Symptoms. Hernia of the abomasum always occupies a certain 
position in the lower part of the right flank, or, rather, in the space 
comprised between the white line and the lower part of the circle of 
the hypochondrium. 

The immediate symptoms are similar to those of hernia of the 
rumen. They include : progressive swelling, formation of a peripheral 
oedematous ring, interstitial sero-sanguineous exudation, which becomes 
absorbed after a few days ; finally, the development of a hernia, formed 
as a rule by the larger curvature of the viscus, which is in direct con- 
tact with the abdominal wall. 

The lesions are those common to all hernia, and usually include 
a partially healed wound. 

Diagnosis. The diagnosis is easy, particularly in calves, and the 
possible existence of the condition should always be borne in mind when 
dealing with injuries of the right pre-umbilical zone. An abscess of 
the lower abdominal wall may occur at or near the umbilicus as a re- 
sult of omphalitis or umbilical phlebitis, but it is readily distinguished 
from a hernia. 

The prognosis is graver than in the case of hernia of the rumen, for 
the displacement of the abomasum interferes with its regular function. 
The prognosis varies, how^ever, in accordance with the size of the hernia. 
If the rupture is small, there is some chance that the abomasum, on 
account of its longitudinal position, many penetrate but slightly into 
the fissure. 

If, on the other hand, the rupture is large, the prognosis becomes 
very serious. It is sometimes best to slaughter the animal, if in good 
condition ; otherwise an operation is necessary. 



494 HERNIA. 



HERNIA OF THE INTESTINE. 

Causation. This is due to the same cause as hernia of the rumen — 
a blow which, while injuring the skin only to a trifling extent, damages 
the abdominal walls, and even the intestine itself. 

Symptoms. The hernia is situated in the lower or lateral zone of 
the right flank. 

The symptoms present some peculiarities. The loop of intestine 
which has passed through the aperture in the abdominal walls be- 
comes distended by the accumulation in it of semi-liquid alimentary 
material, and, acting by its own weight, produces a hernial sac, which 
steadily grows in size. The skin being very mobile, and the sub- 
cutaneous connective tissue very loose, they readily yield and become 
separated. The inflammatory symptoms disappear, and are followed 
by a swelling under the skin, which is compressible all over, and can 
readily be reduced, whereupon it gives forth a gurgling noise, or a 
sound as of borborygmus. Eeduction is easier when the animal is 
lying on its left side, or on its back. 

Complications. Strangulation of the small intestine is the only 
serious complication in this form of hernia, but it is very dangerous. 
It occurs frequently when the rupture is somewhat highly-placed on the 
lateral portion of the abdominal wall, because the loops of intestine 
haye a tendency to descend, thrusting away the skin owing to the 
weight of material which they contain. 

The partially digested food is apt to accumulate in the herniated 
loop, and hernial engorgement, the first phase of strangulated hernia, 
rapidly occurs. 

Fermentation is set up in the half-digested food, and putrid gases 
are generated. Thus the hernial sac becomes distended, the vessels 
are compressed, circulation is arrested, and gangrene supervenes. 

At this time gurgling sounds and a certain degree of tympanitic 
resonance may be noted. These are followed by all the symptoms 
of intestinal strangulation — namely, intense colic, w^hich suddenly dis- 
appears when the intestine becomes mortified, absolute loss of appetite, 
stoppage of rumination, constipation, suppression of defsecation, tym- 
panites, and peritonitis. 

The diagnosis is comparatively easy at an early stage, owing to the 
peculiar character of the soft swelling, which is easily compressible. 
At first there may be difficulty in distinguishing it from a collection 
of serous fluid, but the facility with which the swelling can be reduced 
removes any doubt. 

The prognosis is always serious, on account of possible complica- 
tions, due to strangulation of the herniated loop. When the hernia is 



TREATMENT OF HERNIiE. 495 

chronic, reduction is much more difficult, there heing, as a rule, adhe- 
sions between the intestine and the hernial sac. 

TREATMENT OF HERNIA. 

Numerous attempts have been made to treat abdominal hernia in 
bovine animals. 

Irritant and vesicant applications to the skin have been recom- 
mended, with the object of producing a large swelling, and thus 
thrusting back the herniated mass into its proper position. 

One of the most popular of these applications is nitric acid of a 
strength of 36^ Baume, applied to the skin twice at an interval of 
ten days. Skilfully used, it gives good results in umbilical hernise, 
but its effects in ventral herniae are less certain. It causes slow 
mortification of the skin, abundant subcutaneous sw^elling, and pro- 
duces an eschar, which separates in about a fortnight. 

An ointment of yellow chromate of potash (1 to 8) has been recom- 
mended, and can be a23plied two or three times at intervals of eight or 
ten days. 

Bandaging and various forms of local dressing have also been em- 
ployed from time to time. Serres employed simple bandages similar 
to those used in cases of inguinal or crural hernia in human beino-s. 
These bandages have a pad, which is applied over the hernial opening, 
but their action is strictly palliative. They simply allow of the animal 
being kept a certain length of time for fattening. 

When the hernia has been reduced recourse may be had to bandages 
saturated in melted pitch, care being taken to extend the dressing a con- 
siderable distance beyond the limits of the hernial openino-. Successive 
layers of bandage are superposed across and across, and, to make the 
dressing more solid, the pads may be reinforced with a sheet of solid 
cardboard. This method only succeeds when the swelling is slight and 
is situated elsewhere than in the lowest portions of the abdomen. 

Some practitioners prefer a cloth bandage after reduction. The 
bandage is ten to fifteen yards in length, and should be considerably 
wider than the greatest measurement of the hernial opening. Such 
bandages can easily be applied to calves, whose bodies are of regular 
shape, but in adults, in which the body is of ovoid formation, they 
prove faulty, and tend to slide backwards or forwards. 

All these measures are merely more or less palliative and of tem- 
porary effect. 

The only rational and radical treatment is surgical. This is clearly 
indicated when the hernia is recent and of small size. At a later stage, 
when fibrous adhesions have formed between the various organs, and 
reduction has become difficult, caution must be observed. Suroical 



496 HERNIA*. 

treatment is always a serious matter, and should only be attempted 
in the case of valuable breeding animals, or those which cannot be sold 
for slaughter. 

Young animals are kept without food for twenty-four hours and 
are cast on the side opposite the hernia ; they can be placed on the 
right or left side, or on the back, as seems most convenient. The 
site of operation is disinfected, and the operation carried out with 
aseptic precautions. The skin covering the swelling is incised and, 
the margins of the hernial orifice having been examined, the sac is 
isolated. Next, an incision is carefully made, any adhesions which may 
exist are broken down and the herniated parts are reduced. It only 
remains to suture the wound with silk or catgut, bringing the lips of 
the fissure together. Finally the skin wound is firmly united, and a 
large suspensory bandage tightly applied. 

If the hernia is of long standing, and is irreducible on account of 
numerous adhesions, operation may still be attempted. In that case 
the incision must be an inch or two longer, all adhesions should be 
destroyed, and the margins of the orifice need to be freshened so as 
to insure their uniting. 

During the days following operation, the animals should have light 
food, principally gruel, mashes and cooked roots. But it must be borne 
in mind that this operation is serious, and may possibly be followed by 
eventration. 

DIAPHRAGMATIC HERNIA. 

The term diaphragmatic or mediastinal hernia denotes a condition 
in which certain of the abdominal viscera penetrate into the thoracic 
cavity. This displacement may be congenital, acquired, or accidental. 

The accidental hernise are of traumatic origin, and are often caused 
by fractured ribs, which injure the diaphragm. The hernia is then 
purely diaphragmatic. 

Congenital or acquired hernise are more frequently mediastinal ; they 
occur exactly in the median plane as a consequence of fissure of the 
diaphragm above the ensiform cartilage, and cause a separation between 
the two layers of serous membrane enclosing the posterior mediastinum. 

The region immediately behind the diaphragm in the ox being 
occupied by the large viscera— namely, the anterior conical portions 
of the rumen, the reticulum, the omasum, and the liver^diaphragmatic 
or mediastinal hernia is far from being common, though occasionally 
it may be discovered or at least suspected. 

Causation. The causes of diaphragmatic and mediastinal hernia 
are closely connected with injuries in the region of the hypochondrium ; 
with arrest in the development of the diaphragm ; or with accidental 
vertical fissuring consequent on gestation or acute tympanites. 



DIAPHRAGMATIC HERNIA. 



497 



The fissure seems most commonly to occm^ between the point where 
the oesophagus passes through the diaphragm and the ensiform carti- 
lage of^the sternum, in which case mediastinal hernise most commonly 
supervene. As, on the other hand, the rumen, owing to its size, form 
and position, cannot readily be displaced, the reticulum and omasum 
are the viscera which most commonly pass into the thorax. 

Symptoms. In true accidental diaphragmatic hernia visceral dis- 
placement only occurs on the right side, and symptoms of this are 
immediately apparent. The passage of the liver, reticulum, or omasum 




Fig. 223. — Intra-mediastinal diaphragmatic hernia (viewed in position from the left 
side). P, Lmig ; C, heart (displaced) ; D, diaphragm; H, hernial mass. 

into the right pleural sac compresses the lung, causes attacks of dyspnoea 
and acceleration of the heart's action. 

Percussion may not reveal any important change, but on auscultation 
digestive sounds can plainly be heard within the chest. 

The symptoms are far from being well defined. They may be more 
or less intense, and colic may or may not be present. Mediastinal 
hernia (Fig. 223) appears to develop slowly, and it is only by degrees 
that the viscera become displaced. 

There is then no sudden change, no clearly marked disturbance, 
but simply a certain amount of digestive irregularity, together with 
loss of appetite, cessation of rumination, slight indigestion, and mode- 
rate tympanites. The disturbance is really due to obstruction in the 
alimentary canal and displacement of the reticulum and omasum, so 
that rumination and deglutition are affected. 

Very often this condition may last for weeks, in either a stationary 

D.C. K K 



498 



HERNliE. 



or more or less aggravated form, so that there is an appearance of 
chronic gastro-enteritis, motor dyspepsia, or chronic indigestion. 

Though a diagnosis in this sense would be correct, the atony of 
the rumen is not primary, but of mechanical origin. 

One indication is constantly present, which might suggest indi- 
gestion due to overloading of the rumen, and which is also seen in 
ulcerative gastritis, viz., progressive stasis of food in the cavity of the 
rumen. When the patients remain for some time under observation, 
this stasis becomes every day more marked, and, being recognised, the 




Fig. 224. — Schema of the position of the organs in the hernia represented 
by Fig. 228. D, Diaphragm ; FF^, hver ; Tl, pleura ; Fe, omasum ; Re, 
reticulum ; CO, abomasum. 



diagnosis becomes easier. Animals suffering from mediastinal hernia lose 
condition, waste away, and in the end may die in a state of cachexia. 

Lesions. The lesions vary greatly. In accidental diaphragmatic 
hernia they are confined to rupture of the diaphragm, sometimes of 
the liver, and to changes in the reticulum or omasum. 

In intra-mediastinal hernia the layers of the mediastinum form a 
true hernial sac, and if the lesion is of old standing the displaced viscera 
may become attached to it, compressed, and partially strangulated. 

Diagnosis. The diagnosis is very difficult, at all events in medi- 
astinal hernia, and can only be arrived at by a process of exclusion. 



EVENTKATION. 499 

The most significant symptom is progressive stasis of food within the 
rumen, suggestive of some obstacle in the alimentary canal. 

Prognosis. The prognosis is extremely grave, because it is im- 
possible to reduce the hernia. 

Treatment. No treatment is possible. The essential point is to 
confirm the diagnosis as soon as possible and to slaughter the animal 
while it is jet in good condition. 

EVENTRATION. 

Eventration belongs to the same group of lesions as hernige, of 
which it is merely a more serious form. It differs from them only in 
the fact that the entire abdominal wall is injured. The skin, muscle, 
and peritoneum are torn, and the digestive organs pass into direct 
communication with the external air. 

The name eventration has also been given .to enormous subcu- 
taneous abdominal hernige, in which the sero-muscular wall is injured 
over a large area and the viscera become displaced and separate the 
subcutaneous tissue layers while at the same time they alter the 
w^hole shape of the abdomen. 

Causation. The cause is always the same — some grave mechanical 
injury to the abdominal wall, producing an extensive perforation. The 
injury may be due to a horn thrust or to the animal falling on some 
sharp -edged body. 

The symptoms are very marked. Through the wound, the rumen, 
the abomasum, or the intestine protrudes more or less. Generally 
it is the small intestine which becomes displaced, because it is the 
most mobile of the abdominal viscera. These organs soon become 
dried by contact with the air, and may become infected, soiled, con- 
gested, thickened, torn, or gangrenous. The successive development 
of these changes causes serious and violent colic, accompanied by ex- 
pulsive efforts ; the animals throw themselves on the ground, and 
may tear the mesentery, the intestines, etc. At an advanced stage 
the animal may stand motionless, looking at its viscera. Death may 
also be caused in a very short time by the intense pain. 

Diagnosis and Prognosis. The diagnosis is evident. The prog- 
nosis is always very grave, although, of course, it depends on the 
condition of the displaced viscera. 

Treatment. It is often useless to attempt anything, and if the 
animal is in suitable condition it is best, as a rule, to slaughter it. 

If the accident is quite recent, and the viscera only slightly injured, 
surgical treatment may be attempted. With this object, the displaced 
organs are carefully and thoroughly washed with lukewarm boiled water, 

K K 2 



500 HERNIA.. 

or with some unirritating disinfectant, to guard against peritonitis, 
and are then reduced. 

The abdominal wound must afterwards be carefully sutured. This 
is performed in two stages. The musculo-serous layer is first brought 
together with catgut, or better still with silk, and the skin joined by 
means of deep and closely-placed stitches. To prevent these sutures 
being torn out, and to support them, the abdomen is swathed in a 
broad cloth bandage, tightly applied. 

FISTULA OF THE DIGESTIVE APPARATUS, 

Fistulse of the digestive apparatus are of accidental origin and of 
relatively small practical interest. In most cases they necessitate 
surgical and other treatment of too delicate a kind and too prolonged 




Fig. 225. — Fistula of the rumen. 

a character to justify the necessary expense. Their nature and origin 
sufficiently suggest the course to be adopted. 

These fistulae are divisible into two varieties, gastric fistulse and 
intestinal fistulae. Gastric fistulae comprise fistulae of the rumen, reti- 
culum, and abomasum. They may be of external origin, but in the 
majority of cases they are produced by foreign objects accidentally 
swallowed and eliminated through the medium of an abscess of the 
abdominal walls. Their position and direction indicate their point of 
origin. (Fistulae of the rumen appear on the left side of the reticulum, 
near the ensiform cartilage and middle line; those of the abomasum 
on the right side, near the middle line.) In doubtful cases, chemical 



FISTUL.E OF THE DIGESTIVE APPARATUS. 501 

analysis of the liquid which escapes will afford valuable information. 
Acidity alone is a sufficient indication in fistula of the abomasum. 

Fistulse of the rumen and reticulum are difficult to close on account 
of their low position in the abdominal wall, but, if great care is exer- 
cised, they may be successfully treated. Those of the abomasum, on 
the contrary, only tend to increase in size, and any surgical inter- 
ference still further favours the destructive action of the gastric juice. 
As a rule, therefore, they cannot be treated. 

Fistulse of the second variety comprise all intestinal fistulae. They 
may be either accidental or artificial, and they are less grave than 
gastric fistulae, because they are rarely situated in the lower portions 
of the abdomen. With time they may become closed either sponta- 
neously or by means of simple treatment tending to regulate the 
passage of food through the bowel. 



SECTION VII. 
GENITO^URINARY REGIONS. 

DISEASES OF THE URINARY APPARATUS* 

Symptomatology. The urinary apparatus comprises the organs of 
secretion (the kidneys) and those of excretion (the ureters, the bladder, 
the urethra). 

A thorough examination of the urinary apparatus should include, 
firstly, that of the external organs (the sheath, glans penis and urethra) 
in the male, and, in the female, the vulva, meatus and urethra ; 
secondly, that of the internal organs (the bladder, ureters and kidneys) 
in both sexes. 

To carry out the external examination, the head must first be fixed 
and the hind limbs hobbled. If necessary, the animal can be attached 
to the side of a wall. 

External examination comprises inspection and palpation, which is 
only possible in males. Inspection will reveal at once the existence of 
malformation, deformity, traumatic lesions, or tumours of the organs. 

By palpation the sheath and glans penis can be examined, and cel- 
lulitis, abscess formation, calculi in the urethra, obstruction of the ex- 
tremity of the canal by very fine gravel, as in the case of sheep, etc., 
can be detected. 

The inner margin of the right kidney may also be examined by 
external palpation, though only in very thin animals. The examination 
is made from the flank region, behind the last rib, in an upward direc- 
tion and towards the right (Fig. 227). The kidney, attached under the 
lumbar region, sometimes extends back beyond the last rib, under the 
transverse processes of the lumbar vertebrae. On the left the presence 
of the rumen prevents any examination. 

In sheep this examination requires special care. 

Examination of the internal urinary organs must be made through 
the rectum. It should be undertaken slowly and gently. In the male 
the hand detects the condition of the organs contained within the pelvic 
cavity, the fulness or emptiness of the bladder, or the existence of calculi 
within it. More deeply seated can be felt the entire length of the right 



DISEASES OF THE URINARY APPARATUS. 



503 



ureter ; its state of dilatation can be felt, and the existence of diverticula 
of inflammation, if any, can be ascertained. The left ureter cannot 
readily be examined, on account of the position of the rectum, except 
as regards the posterior part, close to the bladder and the rumen. 



Cp.Vs. K.U. Ip 




Fig. 226. — Genito -urinary organs in the male (pelvic cavity exposed). Qj, Peritoneal 
cavity (posterior cul-de-sac) ; Vs, vesicula seminalis ; R, rectum ; U, ureter ; Ip, line 
of insertion of the peritoneum ; Cd, vas deferens ; V, bladder ; Agt, testicular 
artery ; C^, inguinal canal ; P, penis ; Cv, neck of the bladder ; Ic, accelerator 
urinse muscle ; Gc, prostate gland. 

In the abdominal cavity the rectum, or rather the floating colon, 
turns to the right, in such a way that, in spite of the shortness of the 
meso-rectum and meso-colon, the hand can be passed as far as the right 
kidney. It is, then, easy to discover whether this organ is sensitive to 
pressure, hypertrophied, atrophied, cystic, etc. The paunch interferes 
with examination on the left side. 



504 



GENITO-URINARY REGIONS. 



In females the ureters and kidneys can be examined in the same 
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through the vagina. About 2 or 2| inches from the vulva on the floor 
of the vagina is the entrance to the urethra, covered with a special valve. 
The meatus becomes visible by separating the lips of the vulva and the 



DISEASES OF THE URINARY APPARATUS. 505 

vaginal walls. For this purpose a speculum ad hoc can advantageously 
be used. It is clear that if it is thought desirable to examine the 
bladder through the rectum, which is not absolutely impossible, the 
vagina will be interposed between the arm and the urinary organs, and 
the sensations experienced will, therefore, be much less clearly defined 
(Fig. 226). 

In passing a catheter for the purpose of emptying the bladder the 
end of the sound should be introduced under the valve of the meatus. 
By slightly lowering the back end of the sound, the front end is lifted 
above the cul-de-sac, and the operator at the same time pushes gently 
forwards. It is then only necessary to lift the hand, and the sound 
passes readily into the urethra and the bladder. 

Examination of the urine and even chemical analysis are of great 
importance in diagnosing diseases of the urinary tract. 

From the clinical point of view very complete analyses are not neces- 
sar}^, but the tests for albumen, sugar, bile pigments and indican are 
absolutely indispensable ; and the same is true of microscopic exami- 
nation for ascertaining the presence or absence of epithelial cylinders, 
blood corpuscles, pus corpuscles, etc. It is important also to note the 
colour and odour and the quantity passed. 

These examinations are by no means difficult. Albumen is detected 
by adding a few drops of acetic acid to the urine, and heating, or by 
adding nitric acid and Esbach's liquid. Esbach's albumenimeter is suf- 
ficiently exact to discover the approximate amount of albumen present. 
Sugar is detected by the use of Fehling's solution, bile pigments by 
nitric acid, and indican by adding a few drops of 10 per cent, chloride of 
calcium solution and hydrochloric acid. Should indican be present a 
more or less deeply tinted indigo blue circle appears, resulting from its 
oxidation. 

Hippuric acid is precipitated by pure hydrochloric acid. 



CHAPTER I. 
POLYPI OF THE GLANS PENIS AND SHEATH. 

In young animals the extremity of the glans penis and the margins 
of the sheath are not infrequently studded with polypi, soft swellings of 
papillomatous or verrucous appearance, sometimes of considerable size, 
which interfere with micturition, and deform the glans. The existence 
of these growths is shown by very well marked signs — viz., difficulty in 
micturition, deformity of the sheath, deviation of the jet of urine, ob- 
struction in the passage of the penis, and more or less marked deformity 
of the penis itself. 

These polypi are of the same nature as those so common in dogs, 
viz., papillomata. 

The diagnosis is very easy. On digital examination the growths 
are almost always found at the base of the sheath. 

At an early stage the prognosis is benign, provided intervention is 
promptly undertaken. If the disease is of old standing, or is not treated, 
the animals may become somewhat thin. They suffer pain, caused by 
retention of urine and inflammation of the sheath ; urethritis may even 
be set up. 

The treatment is fairly easy, and is exclusively surgical; but as it 
necessitates casting the animals the bladder should first be examined 
per rectum, and operation should never be attempted until the bladder 
has been emptied so as to avoid possible rupture. The animal being 
fixed on its back, the penis is withdrawn from the sheath, and the 
polypi can then be snipped off with scissors, the wounds being slightly 
cauterised to arrest haemorrhage : in the case of the sheath, rather ex- 
tensive wounds must sometimes be produced ; these may be sutured. 

To prevent the wounds afterwards becoming infected and suppurating, 
the sheath should be regularly washed out with an antiseptic solution 
and the animal kept on a very clean bed. 

INFLAMMATION OF THE SHEATH. 

This condition is much more common in the ox than in the horse on 
account of the different anatomical structure of the parts, and the 
methods of keeping and using oxen. 



INFLAMMATION OF THE SHEATH. 507 

Causation. Several predisposing causes undoubtedly exist. The 
sheath is prolonged beneath the abdomen to a considerable distance 
beyond the glans. It is narrow, deeply seated, and, during micturition, 
not even the point of the penis passes beyond it. The urine, therefore, 
soils the interior, or a certain quantity may be retained, according to 
whether the orifice is more or less obstructed by urinary sediment, 
sebaceous material, manure, or other material. Moreover, experience 
shows that of all the large ruminants, those used for outdoor work are 
the most affected. 

Of the occasional causes, if we except sebaceous and urinary pro- 
ducts, the most important is mechanical violence, such as the lacera- 
tions or wounds produced by the bed-piece of the trevis when the animal 
is being shod. The working ox throws its whole weight on this bed- 
piece, on which it lies on one side or the other, according to the foot 
which is being lifted. The sheath is compressed, and if the animal is 
heavy and struggles, the parts may be abraded and torn, or the sheath 
and even the glans may be crushed. In less dangerous cases the con- 
nective tissue may be lacerated by the edge of the bed-piece. Any 
injury so inflicted is aggravated by dirt in the neighbourhood. 

Symptoms. The first signs which attract attention are of a general 
character, and seldom very strongly marked. The animal shows slight 
fever, dryness of the muzzle, is restless and continually moves about, as 
though to get rid of the ^^ain it feels. The hind limbs are frequently 
lifted. In this attitude it makes efforts to urinate, but urine is passed 
very slowly, and the act seems painful ; then, later on, the appetite 
diminishes, rumination is suspended, and, as in all intense forms of 
cellulitis, complications may occur. 

The local symptoms are more suggestive. The slowness and diffi- 
culty with which urine is passed at once attracts attention to the 
diseased parts. Examination immediately reveals extreme sensitiveness 
of the sheath, although as yet there is only slight engorgement. At a 
later stage a large swelling develops and extends along the abdominal 
wall on either side, sometimes upwards into the groin. In certain cases 
the sheath may be totally obstructed by sebaceous and inflammatory 
material, and in the absence of surgical assistance the bladder may 
become ruptured. 

Inflammation most frequently ends in the tardy formation of an 
abscess, which shows little tendency to open spontaneously. It is 
usually accompanied by gangrene and by mortification of a mass of 
skin and subcutaneous tissue, sometimes of portions of the abdominal 
tunic. Such grave complications may even lead to the opening of 
an artery, and to fatal haemorrhage. 

All these symptoms develop comparatively slowly. Abscesses scarcely 



508 



URINAKY APPARATUS. 



ever appear before the twelfth or fifteenth day, but when the disease 
is not treated it may continue as long as five or six months. On 
the other hand, resolution is the ordinary termination under suitable 
treatment. 

Diagnosis. The diagnosis is easy when the exact facts can be 
ascertained. The difficulty in micturition is the chief indication. At 
a later stage, local swelling and acute sensitiveness are characteristic. 
^ Prognosis. The prognosis is grave, having regard to possible com- 
plications and the chronic character which the inflammation tends to 
assume. 

Treatment. When the sheath is filled with sebaceous material or 
foreign substances it may be necessary to cleanse it daily with mild 
antiseptic injections. Some practitioners recommend laying open the 
external orifice, an operation which may be performed in the stand- 
ing position. This, however, is not without danger, and infection 
may easily occur. 

When the subcutaneous connective tissue surrounding the sheath 
and the glans penis is infiltrated and inflamed, the inflammatory 
swelling must be examined every day, so as to detect the abscesses as 
early as possible, and open them without delay. Under some circum- 
stances deep firing in points produces very favourable results. 

When an abscess has caused partial necrosis of the sheath, it is 
well^ to pass a drain and wash out the parts frequently with anti- 
septic solutions. For this purpose a counter-opening is made through 
the skin opposite the fluctuating point. The mucous membrane of 
the sheath is then cautiously punctured, and a seton or strip of 
gauze is passed by means of a seton needle, so as to allow of con- 
stant drainage. 

PERSISTENCE OF THE URACHUS, 
This condition is an infirmity or congenital anomaly, rather than 
a morbid condition. Persistence of the urachus after birth and after 
separation of the cord is due to the fact that the canal which com- 
municates with the bladder fails to close up. The urine, instead 
of escaping through the urethra, passes along the urachus, and the 
animal urinates through its umbilicus. 

Causation. The causes are simple. Certain practitioners have sug- 
gested that sex has some influence, this being an anomaly occurring 
more frequently in males than in females. From investigations which 
have been carried out, it would appear tlmt, in some cases, persistence 
of the urachus is due to an imperforate condition of the urethra ; in 
other cases, to its obstruction by accumulations of mucus of a caseous 
appearance, which enter the urethra and completely block the passage. 



PERSISTENCE OF THE URACHUS. 509 

Finally, in other cases the urachus simply persists while no lesion 
exists on the side of the urethra. 

Whatever the original cause, escape of urine by the umbilicus pro- 
duces irritation, which may end in complications, infection of the 
unhealed umbilical wound, infection of the canal of the urachus itself 
and the bladder, or even infection of the peritoneum. 

Symptoms. At first, persistence of the urachus is shown by per- 
manent or intermittent discharge of urine through the umbilicus. 
Usually this discharge is only seen from five to eight days after 
birth, when the necrosed cord is detached ; in most cases it is con- 
tinuous, for the opening is abnormal and has no sphincter. 

Contact with the air and the wound causes the urine to undergo 
a kind of ammoniacal fermentation and to irritate neighbouring tissues, 
such as the stumps of the umbilical vessels, the interstitial connective 
tissue, and even the skin. The wound constitutes an excellent culture 
medium for microbes. The umbilicus becomes swollen and oedematous, 
and soon exhibits a saccular swelling, 2 to 4 inches in diameter, which, 
on palpation, proves to be hot and painful ; its centre is occupied 
by the opening of the urinary fistula. A probe passed into this 
fistula travels upwards and backwards (see Fig. 183). 

At a later stage other complications, including omphalitis and 
omphalo-phlebitis, may set in. The most frequent of the delayed com- 
plications is purulent cystitis, with the formation of purulent concre- 
tions in the bladder, which may occur even after the fistula of the 
urachus has healed. In other cases the canal of the urachus con- 
tracts and becomes obliterated towards the bladder. A blind fistula 
then persists, with an opening at the umbilicus, or, the parts having 
healed externally, all that remains is a phlegmonous swelling with 
the characteristic symptoms. 

Diagnosis. A thorough examination will invariably allow of urinary 
fistulse being distinguished from other diseases of the umbilicus, the 
escape of urine at this point being so suggestive. 

Prognosis. The prognosis is rather grave, on account of the com- 
plications, which are possible, and, in fact, usual, unless the disease 
is promptly diagnosed. 

Treatment. Formerly as a preventive measure a ligature was ap- 
plied to the whole mass of the cord at birth, but this ligature in no 
way prevents the canal of the urachus persisting after the atrophied 
portion separates. Cauterisation of the urinary fistula with Eabel's 
fluid or tincture of iodine can have no good result, unless the 
urethra is permeable. 

If the urethra is obstructed it is evidently from that side that treat- 
ment should be attempted, either by displacing the muco-albuminous 



510 



URINARY APPARATUS. 



plugs with a catheter or in some other way. Such intervention is 
very dehcate and difficult in the case of young animals. Sometimes it 
is better to allow the discharge of urine from the umbilicus to continue, 
and to recommend that the animal should be rapidly fattened for the 
butcher. 

In practice, pervious urachus may be treated by suturing, by firing 
across the fistula, and sometimes by blistering. The first step in all 
cases is to see that the urethral passage is free. EngHsh veterinary 
surgeons claim to have had a fair measure of success from these 
m^ethods. 

If a radical cure were thought desirable, the abdomen would have 
to be opened, and the operator would proceed to isolate the urachus, 
resect it, and suture the base of the bladder by bringing together its 
external surfaces. The operation, though not perhaps impossible, is 
of no practical value. 



I 



CHAPTER II. 

DISEASES OF THE BLADDER. 
ACUTE CYSTITIS. 

Cystitis, or inflammation of the bladder, may be divided into two 
varieties : simple (acute or chronic) C3^stitis, and chronic cystitis due to 
the presence of calculi. 

Simple acute cystitis occurs most commonly in the cow, less fre- 
quently in the ox, and rarely in the pig or sheep. Female animals 
are more subject to it than males. 

It consists of more or less acute inflammation of the vesical mucous 
membrane. The inflammation sometimes extends to the muscular coat 
and the peri- vesical tissues, setting up local or general peritonitis. 

Causation. The internal causes to which Cruzel attributes the 
disease are rather open to question. Eetention of urine in particular 
is common in working oxen, which only pass urine when resting, and 
this would be more likely to produce distention, paralysis, or rupture 
of the bladder than true inflammation ; it is doubtful whether inflam- 
mation would even follow the chronic irritation resulting from fre- 
quently repeated over- distention. 

The ingestion of irritant plants certainly has a more marked action. 
Irritant principles eliminated by the kidneys might not injure them, 
although they w^ould bring about changes in the vesical mucous mem- 
brane, with which they would remain in contact for some time. 

More frequently cystitis is the result of inflammation due to con- 
tinuity of tissue, and forms a complication of urethritis, vaginitis, 
and the conditions set up by retention of the after-birth. It may 
also result from ascending infection causing pyelo-nephritis, or ascend- 
ing infection of any kind which eventually attacks the bladder. It 
is a very common consequence of the use of unclean catheters, but 
only in equines and females, as the catheter is not passed in the ox 
or bull until after urethrotomy. 

In by far the majority of cases it is of infectious, and not of toxic, 
origin. 

Symptoms. At first the symptoms are obscure. They commence 
with slight colic, and are afterwards characterised by frequent, difficult 



512 DISEASES OF THE BLADDEK. 

and painful micturition and by the small quantity of urine passed on 
each occasion. 

The urine, moreover, is modified in appearance. At first it con- 
tains a small quantity of blood, and is reddish, or at least of a darker 
tint than is usual. Later it becomes thick and whitish, and contains 
greyish films of epithelium, and the debris of fibrinous coagula. The 
microscope reveals in it the presence of pus corpuscles, flat polygonal 
cells with large nuclei, and sometimes red blood corpuscles. 

Locally almost all that can be detected in male animals is a little 
tenderness of the neck of the bladder on rectal examination, and in 
females on examination of the meatus urinarius by means of a 
speculum. 

The vaginal mucous membrane then appears inflamed around the 
meatus, which itself is exceedingly sensitive. 

In cases of very marked inflammation, accompanied by partial 
necrosis of the mucous membrane or the production of false mem- 
branes, the temperature rises as high as 104° Fahr. (40° C), appetite 
disappears, colic is extremely acute, and violent efforts to pass urine 
are continually made until the animal is completely exhausted. The 
patient then refuses to walk about, but frequently lies down, arches 
its back, and constantly makes efforts to urinate, which are abortive 
or end only in the passage of little jets of fluid. 

The urine passed contains little greyish necrotic fragments or cUhris 
of false membranes, suggestive of diphtheria. In female animals the 
canal of the urethra may also become obstructed, and rupture of the 
bladder, though rare, occasionally occurs. 

In the ordinary forms inflammation persists for two to three weeks, 
then diminishes in intensity, and either ends in recovery or becomes 
chronic. 

In the grave forms, where inflammation and infection extend to the 
peri-vesical tissues and the peritoneum, death by peritonitis is the rule. 

On post-mortem examination, the mucous membrane is seen to be 
of a greyish colour, and sloughing or gangrenous over surfaces of vary- 
ing size, whilst the surroundings are infiltrated, blackish and greatly 
thickened. The whole of the connective tissue layer which supports 
the peritoneum near the base of the bladder, and also the adipose 
tissue around the bladder, are markedly inflamed. At this stage pelvi- 
peritonitis or generalised peritonitis may occur as complications. 

In the simple forms the mucous membrane is desquamating, infil- 
trated, and covered with granulations of apparent healthy appearance. 

Diagnosis. The diagnosis is comparatively easy, the external 
symptoms being so clearly defined. There is a difficulty, however, 
in distinguishing this disease from cystitis caused by a calculus. In 



CHRONIC CYSTITIS. 513 

male animals this latter form of cystitis is characterised by frequent 
spasmodic contractions of the accelerator urinse. In . acate cystitis, on 
the contrary, the contractions are temporary only and of no import- 
ance. Lastly, in female animals cystitis due to calculus formation 
is quite exceptional, owing to the large diameter and shortness of the 
urethra. 

When nephritis and cystitis co-exist certain signs indicate the fact. 

Prognosis. The prognosis varies, according to the acuteness of the 
disease and the character of the urine and epithelial debris, which afford 
valuable information. 

Treatment. The treatment should be directed towards relieving the 
vesical and pelvic pain and modifying the local conditions. 

Hot fomentations to the loins and flanks relieve pain. The adminis- 
tration of bicarbonate of soda and of cold drinks, such as barley-w^ater, 
decoctions of couch-grass and pellitory, mucilage, etc., are of service. 
These materials are readily taken by the patients, and have a soothing 
effect. Camphor also produces good results, but benzoate of soda is 
most useful on account of the disinfectant action produced within the 
bladder, as a consequence of the benzoic acid being separately eliminated 
by the kidney. Repeated washing out of the bladder with antiseptic 
solutions has been recommended, but is open to criticism. Such treat- 
ment is difficult in male animals, owing to the special formation of 
the gians penis and urethra, and in female animals it is by no means 
easy. In all cases of acute cystitis, in fact, the passage of the catheter 
is painful, and as a metal, gutta-percha or hard rubber sound is used, 
the mere contact of the tip of the instrument injures the diseased 
mucous membrane, makes it bleed, and gives rise to danger of auto- 
inoculation, with the possibility of serious results. 

Those who recommend this method of treatment can never have 
followed closely the development of a grave case of acute cystitis, and if 
the practice is at all permissible, only a soft catheter should be used. 

In chronic cystitis, on the other hand, washing out the bladder might 
be useful. 

CHRONIC CYSTITIS. 

Chronic inflammation of the bladder is still rarer than acute cystitis. 
It usually attacks females as a consequence of acute inflammation, though 
the condition may be chronic from the first, in which case the early 
stages are commonly overlooked. 

Symptoms. The chief functions of the body do not appear to be dis- 
turbed, although the urine seems abnormal. Micturition is difficult, slow, 
and somewhat painful, and is followed by long-continued tenesmus. 

The urine appears whitish, purulent, slimy, or of a deeper tint, 

D.C. L L 



514 DISEASES OF THE BLADDER. 

rapidly becoming blackish. It is of ammoniacal or foetid odour, and 
decomposes quickly. 

The period of development may be prolonged, and recovery rarely 
occurs spontaneously^ The condition often leads to ascending infection, 
inflammation of the ureters, j^yelitis, and nephritis. 

On post-mortem examination of animals slaughtered before com- 
plete wasting has occurred the vesical mucous membrane is found to 
be thickened, granulating, or suppurating. The muscular tissue shows 
infiltration and localised sclerosis, and is very irregularly thickened, 
inelastic, and wanting in contractile power. The peri-vesical tissues 
may be chronically inflamed. 

Diagnosis. The diagnosis is easy, provided the peculiar charac- 
teristics of the urine are noted, and an examination is made through 
the vagina of the condition of the walls of the bladder, of the ureters 
and of the kidneys. 

Prognosis. The prognosis is grave, because treatment would occupy 
too much of the practitioner's time to allow it to be rigorously carried 
out, and therefore animals are usually slaughtered. 

Treatment. Treatment comprises the use of many of the drugs 
used in acute cystitis, particularly benzoate of soda, benzoic acid, and 
bicarbonate of soda. The medicines comprised in the balsamic group 
are also valuable, viz., turpentine, tar, and terpin. 

In this chronic form the bladder should be irrigated, but this must 
be done with strict aseptic precautions, the fluids used being cooled 
boiled water, boric acid or borax solution of 3 per cent, strength, or 
solution of fluoride of soda of a strength of 15 grains to the quart. 

We need not point out the difficulties of pursuing this treatment in 
ordinary practice. As a rule, treatment is confined to internal medi- 
cation whilst the animals are fattened. 



URINARY LITHIASIS. CALCULUS FORMATION, 

Normally the urine contains in solution certain salts, such as urates, 
hippurates and phosphates of lime, magnesia or ammonia. Under cer- 
tain circumstances, in animals predisposed to the condition, these salts 
are precipitated in the kidneys, ureters or bladder, and form powdery 
or sandy deposits known as sediments ; or, on the other hand, calculi, 
produced by the adhesion of the powdery masses. This constitutes 
urinary lithiasis. 

The sediments are of a greyish-yellow colour. 

The calculi are generally rose-coloured, white or somewhat grey. 
They contain oxalates and carbonates of lime and magnesia, earthy 
phosphates, etc. In appearance and shape they vary greatly. They 



URINARY LITHIASIS. 515 

may resemble coral or may form growths of a romicled, polyhedric or 
raspberry appearance. Some are hard and resistant ; others friable. 
They vary in size between that of a grain of sand and a hen's egg or 
more. A large calcuhis is usually solitary ; the smaller sizes are often 
multiple. 

Calculi occur in oxen and sheep, but more particularly in the latter 
sjDecies. They develop slowly without producing any marked external 
signs, and often it is only when the urethra becomes obstructed and 
urine is retained that the diagnosis is established. Calculi are rare 
in females in consequence of the dilatability of the urethra. 

CALCULI IN BOVINE ANIMALS. 

Causation. The older writers believed that calculi developed through 
winter feeding and a stinted supply of water. Nowadays this would not 
apply to well-managed establishments, water being provided regularly, 
and winter feeding comprising roots, etc., rich in water. Experience 
and observation have shown that the chief cause is excessive feeding, 
calculus formation occurring most frequently in animals which are 
most richly fed. 

Nevertheless, it would be a mistake to overlook the effects of 
temperament and constitution. In human medicine the importance 
of hereditary predisposition and of the special diathesis is undeniable 
(uric or gouty diathesis). In veterinary medicine the same thing- 
applies, for, apart from rich feeding, it is not uncommon to meet with 
cases of gravel in animals living under the most diverse conditions, 
although the issue of the same parents. 

Certain infections of the urinary passages, though trifling at first, 
or at least of slow development, are also capable of causing mineral 
deposits in the urinary passages, a fact which Moussu considers to be 
proved by his success in experimentally reproducing given forms of 
pyelo-nephritis. 

Symptoms. The symptoms are often overlooked, as long as the 
calculus deposits affect only the kidneys, their increase in that part 
not giving rise to alarming symptoms. It is certain that the eventual 
passage of the calculus through the ureter towards the bladder causes 
nephritic colic, but this form of colic is little understood, and has 
never been w^ell described. Writers have simply mentioned cases of 
colic accompanied by great tenderness in the lumbar region, temporary 
suspension of the secretion of urine, and more or less marked dysuria. 

Nothing resembling the extremely grave symptoms of nephritic colic 
in mankind has been described, though probably there is little differ- 
ence in the complaint as it affects the bovine species. 

LL 2 



516 DISEASES OF THE BLADDER. 

When the sediment or the calculus reaches the bladder there is a 
tendency for it to be passed during micturition. The signs then become 
more strongly marked, because they point to obstruction of the urethra. 
If the deposit is simply of the nature of sediment, there is merely a 
little difficulty in urination, accompanied by some moderate amount of 
pain, and sediment is afterwards found within the sheath or adhering 
to the groups of hair at its extremity. 

If, however, the deposit is in the form of small calculi, these are 
pushed towards the neck of the bladder and the urethra, which then 
appears to be obstructed. 

The obstruction may occur at the origin, at the ischial curve, or 
at the S-shaped curve of the penis (Fig. 226). Henceforth strongly 
marked and unmistakable symptoms rapidly develop. Vesical colic 
appears, owing to retention of urine, and rapidly acquires extreme 
intensity, though it instantly ceases with rupture of the bladder in 
cases where no treatment is attempted. This form of vesical colic is 
accompanied by continual but unsuccessful efforts to urinate and by 
spasmodic contractions of the accelerator urinae. 

Appetite and rumination cease, and the animal shows extreme anxiety. 
Palpation along the course of the penis reveals unusual tenderness, and 
the calculus can sometimes be felt near the S curve, though more fre- 
quently in the ischial arch. The litter is not soiled with urine. 

Cautious rectal examination proves the bladder to be extremely 
distended, or, in the case of rupture having occurred, entirely col- 
lapsed. In the latter case the spasmodic contraction of the accelerator 
urinse completely ceases soon after rupture, and the animal appears to 
be recovering. This deceptive calm is due to the disappearance of the 
vesical colic, but the animal's condition is still graver in consequence, 
and it must of necessity die. Kupture of the bladder is followed by 
inundation of the peritoneal cavity with urine, which is partly re- 
absorbed by the peritoneum, producing a kind of urinary intoxication, 
so that despite the elimination of certain volatile principles through 
the lungs (the breath has an odour suggestive of urine), the animal 
very soon dies. 

In many cases, also, the urine is not aseptic, and after rupture of 
the bladder acute peritonitis supervenes and carries off the patient in 
from six to ten days. 

Even when the urine appears to be aseptic, chronic exudative peri- 
tonitis is produced by the irritant action of the urine on the peritoneal 
endothelium. The exuded liquid mixes with the urine, and the animal 
soon shows marked ascites. Despite this condition, some animals have 
been known to survive as long as from three to six weeks without 
showing very marked disturbance. 



URINARY LITHIASIS. 517 

Death is the mevitable sequel after a longer or shorter time. When 
large calculi have been arrested, or rather developed, in the bladder 
the same symptoms occur should the calculus be thrust towards the 
neck of the bladder so as completely to obliterate the passage. This, 
however, is a very rare accident. As a rule the obstruction is merely 
temporary, and the resulting vesical colic and retention last but a 
short time. The displaced calculus falls back again into the lower 
part of the bladder, where it is retained, and the urinary passages 
again become free. 

Diagnosis. The diagnosis is sometimes extremely easy, but it may 
present serious difficulty. 

When the urethra is obstructed, the symptoms are so striking that 
there can scarcely be any doubt ; but the diagnosis of renal calculus, 
nephritic colic, calculus in the bladder, and rupture of the bladder 
demands more attention. Examination of the urinary organs through 
the rectum then proves of great service. 

Prognosis. The prognosis is grave in all cases, because of the pos- 
sibility of the urinary passages being obstructed, so that surgical inter- 
ference is necessary. 

Lesions. The lesions caused by urinary calculi may vary greatly.. 
Though insignificant and scarcely apparent in certain cases, they are 
often very marked, and comprise simple or suppurative pyelitis, in- 
flammation of the ureters, hydro-nephrosis, cystitis of varying intensity, 
urethritis, and inflammation of the sheath. 

Treatment. All farmers who fatten their animals know that the 
use of alkaline drugs, such as bicarbonate of soda, together with 
diuretics, linseed, barley and pellitory diminish the danger of urinary 
calculus formation. Bicarbonate of soda is often given with this object, 
and is excellent in cases where lithiasis does not extend beyond the 
production of sandy or muddy deposits. By rendering the urine more 
alkaline it prevents the growth of sabulous deposits, and may even 
cause slow but progressive solution of concretions already formed. 
When, on the other hand, the urethra is obstructed, and urine is 
retained, early surgical treatment (urethrotomy) alone offers any chance 
of preventing rupture of the bladder. 

Certainly it is jDossible, as recommended by the older practitioners, 
to try massage of the glans penis and urethra opposite the obstruction, 
and, after withdrawing the penis, to attempt to loosen and eject the 
obstructing matter. But such attempts very frequently fail, because 
the material is too firmly fixed, and no time must be lost. 

Urethrotomy is usually practised at one of two points, according to 
circumstances — firstly, opposite the ischial arch; and, secondly, opposite 
the S- shaped curve. 



518 DISEASES OF THE BLADDER. 

Ischial urethrotomy is the promptest method of affording rehef, 
and should always be preferred whenever there is danger of rupture 
of the bladder. 

It is performed in the standing position, but is only possible when 
the animal is not too fat. 

In other cases urethrotomy is performed opposite the point where 
the calculus is fixed, and aims at removing the obstruction. It can 
only be practised after casting the animal ; but, in this case also, it is 
indispensable that the animal should not be excessively fat, as in such 
cases a secondary urinary abscess is almost certain to form. 

Should the animal be so fat as to render treatment difficult, it is 
best to slaughter it at once. 

URINARY CALCULI IN SHEEP. 

Urinary calculi are commoner in sheep than in oxen, and seem to 
depend more on the breed and on conditions of feeding. They are 
almost exclusively confined to animals which are richly fed, to show 
animals, and to males. In exceptional cases they are seen, under 
ordinary conditions of feeding, in aged subjects. 

Calculus formation can moreover be induced experimentally, and in 
a relatively short time, by giving certain rations — e.g., 7 lbs. per day 
of maize, lentils and beans for adults, and 3 lbs. for lambs. The other 
favouring circumstances, viz., hereditary gouty diathesis and infection, 
are less well established than they are in the case of the ox. 

In sheep the symptoms are still less characteristic than in oxen, 
for which reason gravel in sheep merits special description. 

It shows itself in the passage of turbid urine, forming a deposit at 
the extremity of the sheath, which becomes somewhat inflamed. The 
colic resulting from retention of urine is shown by depression, want 
of appetite, dysuria, and generalised convulsive shivering fits. 

The patients lie down in the sterno-abdominal or sterno-lateral posi- 
tion. They constantly suiTer from attacks of general violent shivering, 
and die after twelve, twenty-four, or forty-eight hours. 

On post-mortem examination the bladder is found to be ruptured, 
or the urethra obstructed. 

Diagnosis. The diagnosis involves no difficulty, provided the method 
of feeding is understood. In many cases the shepherds themselves per- 
fectly recognise the cause of the symptoms. 

Prognosis. The prognosis is very grave, it being impossible to pass 
the catheter on account of the perineal valve in the urethra, while it is 
difficult to operate, the urethra being very small and deeply embedded 
in a thick layer of fat. 



EVERSrON OF THE BLADDER. 519 

Treatment. The only resource is massage along the urethra, which 
may sometimes break up the mass of sediment or move the obstruct- 
ing calculus. One remark may, however, be made, viz., that in the 
majority of cases the urethra is obstructed at its extremity by local 
accumulations of sediment behind the spiral filiform prolongation of 
the penis. 

It is then sufficient, and experienced shepherds have no hesitation 
in performing the operation, to remove the spiral filament, thus facili- 
tating the expulsion of the sediment and affording relief. If both 
methods, viz., massage and section of the filament, fail, the animal 
should be slaughtered, so as to avoid rapture of the bladder, which 
would render the fiesh useless as food. 

From a preventive standpoint, all sheep which are richly fed should 
receive an allowance of some slightly alkaline drink. 

PARALYSIS OF THE BLADDER, 

Paralysis of the bladder is somewhat frequent in female, but very 
rare in male, animals. In the majority of cases it is the consequence 
of difficult parturition, or is a post-partum complication. 

It is characterised by incontinence of urine or retention with over- 
flow. The continuous discharge soils the hind quarters, hocks, shanks, 
pasterns, etc., and the urine decomposes and causes irritation ; it soon 
sets up urinary eczema in all the parts with which it comes in contact, 
a condition which can only be successfully treated by removing the 
cause. 

The prognosis is grave, for methods of treatment are few, and of 
doubtful efficacy. 

Treatment. If the condition results from post-partum infection, 
this must naturally first receive attention. Should the infection have 
disappeared whilst incontinence of urine still continues, the adminis- 
tration of tonics, e.g., tincture of nux vomica in daily doses of f to 
1 drachm for ten days or so in the case of a bovine animal, and a 
stimulating a23plication to the lumbo-sacral region, may bring about 
recovery. 

But if, in spite of such treatment, the incontinence persists, it is 
better, from an economic standpoint, to treat the urinary eczema with 
astringents, etc., and quickly to fatten the animal. 

EVERSION OF THE BLADDER. 

Eversion of the bladder only occurs in female animals after difficult 
parturition. The viscus is turned completely inside out, as occurs in 
eversion of the uterus, the base of the bladder becoming invaginated in 



520 DISEASES OF THE BLADDER. 

the cavity of the bladder itself, and afterwards passing into the urethra 
and vagina. The bladder thus becomes totally displaced, and appears 
between the lips of the vulva, resting on the inferior commissure, and 
forming a mass the size of an orange. 

Eversion cannot occur unless the ligaments of the bladder have 
become relaxed, stretched or ruptured. Expulsive efforts and the 
pressure of the intestinal mass complete the process, the peritoneum 
and peri-vasicular layers of connective tissue being torn. 

Diagnosis. The diagnosis of eversion of the bladder presents no 
difficulty. The everted mass aj)pears to have a narrow neck opposite 
the meatus, and is seen to form a reddish, unctuous mass. The mucous 
membrane now forms the external coat and appears covered with mucus 
so long as inflammation does not occur. 

The urine continually escapes from the ureters (which open on the 
surface of the mucous membrane) as it is formed, and flows aw^ay by 
the lower commissure of the vulva. The vulva is half open, and the 
prominence formed by the bladder projects beyond it. 

Prognosis. The prognosis is grave, because reduction is difficult, 
and may be accompanied by rupture of the organ ; also because even 
in favourable cases it is invariably followed by acute cystitis. 

Treatment. Treatment is confined to reduction. Before attempting 
this, measures must be ado^Dted to prevent straining, either by passing 
a rope round the animal's body, thus causing it to flex the vertebral 
column, or by puncturing the rumen or performing trficheotomy. The 
open hand is then applied to the surface of the swelling, which is gently 
compressed and thrust in turn through the meatus and urethra. The 
portions nearest to the urethra should first be returned. It is some- 
times necessary to use both hands, and even to employ a catheter with a 
large round head, to reduce the eversion effectually. After reduction a 
truss or vulval clamp should be applied. Subsequent treatment con- 
sists in the administration of sedatives — e.g., laudanum, mucilaginous 
drinks, barley-w^ater, pellitory, etc. 

HEMATURIA. 

Hgematuria, i.e., the passage of blood-stained urine, is in itself only 
a symptom, which may accompany very varying conditions, such as 
the congestion peculiar to the early stages of nephritis, traumatic 
lesions of the kidneys, ulceration of the uriniferous tubules, or of the 
pelvis of the kidney, lesions of the ureters, bladder, etc., etc. The term, 
therefore, does not indicate a disease, but nevertheless in bovine practice 
the term hsematuria has acquired a special significance. 

This hsematuria of bovine animals is clinically indicated by the 
presence of blood in the urine ; anatomicallj by lesions of the bladder^ 



HiEMATURIA. ,521 

sometimes also of the ureters. It is probable that some forms at least 
of the condition will ultimately be proved to be due to the piroplasmata, 
but in the present state of our knowledge the disease can only be 
described from the clinical standpoint. The reader is recommended to 
refer to the article on " Bovine Piroplasmosis," ante. 

Pichon in 1863 and Sinoir in 1864 introduced the name "hapma- 
turia" in the course of their remarkable investigations concerning the 
disease. Vigney in 1845 and Gillet in 1862 had previously described 
it, and it has since formed the subject of constant researches. 

Detroye in 1891 termed it " essential hpematuria," and Galtier in 
1892 gave it the name of " h?emorrhagic cystitis." Boudeaud in 1894 
also used the term '^hsematuria of bovine animals." In Germany 
the disease is known as " stallroth " (stable-red). 

Geographical distribution. Haematuria is a perfect scourge in cer- 
tain countries. It seems to have made its appearance in the depart- 
ments of the West of France, the Mayenne and the Sarthe, afterwards 
spreading into the Maine-et-Loire and the Indre, At the present day, 
it inflicts great ravages in the Creuze, the Correze, Haut-Vienne, 
Cantal and Haute-Loire districts. It has been described in Germany, 
Belgium, and Italy. These forms are probably due to Piroplasma 
higeminum. 

Causation. The most varying opinions have been advanced regard- 
ing its cause, Pichon believed its appearance was due to changes in 
cultivation, which between 1830 and 1860 completely altered the general 
appearance of the country and the conditions of breeding in the old 
province of Maine. Land reclamations and the use of lime dressings 
have been mentioned, as well as the introduction of the Durham breed 
of cattle. Sinoir practically adojDts the latter view, for he considers that 
the crossing with the Durham breed, wdiile increasing the precocity, has 
diminished the powers of resistance of the indigenous cattle. 

But in course of time these ideas have become modified, and in- 
vestigation has taken a new direction. Detroye regarded the disease as 
a microbic and easily transmissible disorder, while Galtier in the follow- 
ing year described it as merely a chronic hsemorrhagic cystitis, produced 
by the consumption of irritant plants in animals previously suffering 
from distomatosis. In Germany, Arnold attributed •' stallroth " to 
coccidia developing in the epithelium of the vesical mucous membrane. 

Cruzel considered the disease to be due entirely to poor feeding. 
Boudeaud thought the same. He says that hematuria affected one- 
tenth of the whole of the oxen in the south of the Indre and the north 
of the Creuze, in parts where the arable soil is thin and poor in phos- 
phoric acid. Furthermore, he suggests that dressings with lime and 
phosphates would result in the disappearance of hsematuria. 



522 DISEASES OF THE BLADDER. 

We cannot admit that poor forage and feeding alone are sufficient 
to produce hsematuria, for one frequently sees poorly nourished animals 
pass through all the stages of wasting and most profound cachexia with- 
out ever showing signs of this particular ailment. Besides, hgematuria 
may attack animals in good condition. 

Detroye's early opinion as to the infectious or microbic nature of 
the disease seems scarcely more acceptable, for it now appears certain 
that the organism originally described is incapable of producing the 
disease. 

Galtier's theory is still less admissible. According to the Lyons 
professor, hgematuria occurs only in animals suffering from distomatosis. 
The liver, he says, being affected by the growth of liver flukes, no longer 
performs its proper work of destroying toxins, and if under these con- 
ditions the animals eat improper food containing ranunculaceae, sedges, 
rushes, etc., the toxic principles of these plants are absorbed. Then, 
he adds, these principles being no longer destroyed, are eliminated by 
the kidneys, their stay in the bladder causes irritation, and hgemorrhagic 
cystitis is set up, this being afterwards maintained by microbic agents 
in the bladder. 

This very specious theory, all the points in which may readily be 
refuted, in our opinion falls to the ground before the simple fact that 
haematuria occurs in animals which present no trace of distomatosis 
on post-mortem examination, and that, furthermore, it is not seen in 
the lower regions of the departments of the Nord, the Pas-de- Calais 
and the Somme, where ranunculacese and other irritant plants are 
common and distomatosis rages. 

Moussu states that he has proved that haematuria is very rare in 
young animals and is exceptional befoj-e the age of two and a half 
years or three years ; that it attacks oxen as often as cows ; that it 
is particularly common in low regions ; and that it is scarcely ever 
seen above a height of 800 yards. Careful investigation, moreover, 
shows that the passage of blood occurs just as frequently in winter, 
when the animals are housed, as in spring, when at pasture. 

Lesions. The lesions of haematuria are to be found in the bladder, 
though in exceptional cases they may also affect the ureters and kid- 
neys. They have been described by Pichon and Sinoir, but as these 
observers regarded the condition as a disease of the blood due to poor 
feeding, etc., they did not attach much importance to them. Detroye 
has described the different appearances very well, though Moussu 
states that he has never met with the " blisters " which he mentions. 

The first period is accompanied simply by abnormal vascularity of 
the bladder, which appears in the form of true varicosities of the 
gub-mucous vessel^ and intra-mucous capillaries. But if this lesion 



HEMATURIA. 523 

is primary, it does not correspond to the period during which blood- 
stained urine is passed, and is .not sufficient to explain it. It always 
appears in the form of a more or less abundant haemorrhagic intra- 
mucous, sub-e23ithelial spotting. 

Over the haemorrhagic area, which may be of very varied dimensions, 
ranging from those of a small pin's head to those of a lentil, the epithe- 
lium is swollen and loosened, and so separated from the surrounding 
parts as to have lost its vitality. This patch of separated epithelium 
soon falls away, leaving an epithelial ulceration of the mucous mem- 
brane. The subjacent clot rapidly breaks up in contact with the 
liquid in the bladder, and is replaced by a small ulceration which 
becomes the seat of continual capillary haemorrhage. Nevertheless, the 
neighbouring tissues react, and the process of repair may end either 
m true cicatrisation, which appears to be rare, or more frequently in 
the formation of exuberant granulations, which are also of the nature 
of a soft, bleeding vegetation. This vegetation is either sessile or 
pedunculated, and is of very varying size. 

The wall of the bladder also reacts, becoming sclerosed and thickened 
beneath the granulations, so that, in animals which have long suffered 
from haematuria, it may entirely have lost its dilatability. 

When the disease has existed for a certain time, sub-epithelial 
haemorrhages, ulcerations, vegetations and points of sclerosis may all 
co-exist, a fact which shows that the disease does not develop) all 
at once, but that, on the contrary, every little lesion develops sepa- 
rately and continuously. This fact also explains the length of time 
for which blood may be passed, despite the presence of old or healed 
lesions. 

Finally, in very old standing cases dating from several years back 
(Moussu saw an animal aged twenty- eight years which had suffered 
from this disease for more than tw^enty years, but in a very inter- 
mittent fashion), it is not exceptional to find numerous papilliform 
vegetations 1 or 2 inches in length, either with a fine pedicle or 
largely sessile, invading one-half or two-thirds of the internal surface 
of the bladder. 

These vegetations sometimes, though rarely, invade the ureters. 
When they occur towards the point where these conduits enter the 
bladder, they obstruct the passage of urine, and lead to the develop- 
ment of hydro-nephrosis or pyelo-nephritis. 

Symptoms. The early symptoms often escape notice, because 
general disturbance is rare. The first appreciable signs are cystitis 
and frequent urination. 

The urine passed is turbid, particularly towards the end of the act 
of urination ; then it is of a pink or red colour, and all intermediate 



524 DISEASES OF THE BLADDER. 

shades between a pale pink and a bright arterial red colour may be 
observed. 

The patients sometimes seem to pass unaltered blood m the 
urine, but on microscopic examination this blood is found to be 
extremely diluted. Provided the bladder is not gravely infected by 
the (secondary) penetration of germs into its cavity the blood cor- 
puscles remain normal, or are scarcely changed. As soon as the 
bladder, however, becomes secondarily infected an almost immediate 
change takes place ; the red blood corpuscles become crenated, 
broken up and dissociated ; the haemoglobin is also partly dissolved 
and modified, and at this stage the urine is red-brown or coffee- 
coloured, according to the length of time it has been retained in the 
bladder. 

In other cases, chiefly when haematuria has existed for some time, 
the extravasated blood coagulates in the bladder, and the urine passed 
contains filamentous clots the size of a man's thumb, a pigeon's egg, 
or more. If the clots formed are too large to be passed, which is 
often the case in the ox, they may obstruct the urethra, causing 
retention of urine and all the accidents which accompany this con- 
dition, even including rupture of the bladder. This, in the ox, is a 
frequent termination. In the cow the dilatability and shortness of 
the urethra render retention of urine much rarer. It is certainly 
possible, however, and it is not exceptional, to find from 4 to 6 lbs. 
of clotted matter in the distended bladder. All these conditions can 
be detected by rectal exploration, and by attention to the symptoms 
of obstruction of the urethra. 

Whenever there is retention of clots dysuria is extremely marked 
and, so to speak, permanent, the animals having continual tenesmus. 

Hsematuria observes a slow, progressive course, which, in time, ends 
in death by exhaustion, though this is not invariably the case. Haema- 
turia is frequently intermittent, and, after having been very marked for 
weeks or months, may suddenly or gradually cease, and only reappear 
a long time afterwards. This fact is explained by a study of the de- 
velopment of the lesions. When ulceration occurs the sub-epithelial 
vessels of the mucous membrane, which have contributed to the forma- 
tion of the haemorrhagic spot, are widely open, and a capillary haemor- 
rhage results ; but as soon as a small clot forms in this position, or local 
capillary thrombosis occurs, the haemorrhage ceases, with the result that 
the haematuria disappears. Unfortunately, however, the obliterating 
clots are not permanent, any more than the local thrombosis — or, in 
the event of their proving permanent, another small lesion develops at a 
different point, and this lesion may at any time cause the reappear- 
ance of the haematuria ; the process goes on until the animal succumbs. 



HEMATURIA. 525 

Should the lesions heal successively, spontaneous recovery may take 
place, but such recovery is exceptional. 

The animals may not appear to suffer from the passage of blood for 
weeks or even months, but after a time they become less capable of 
replacing the loss. They become ansemic, the number of corpuscles 
falls from the normal figure of from six to seven millions of red cor- 
puscles per cubic millimetre to three millions, two millions, one 
million, and even to five hundred or eight hundred thousand. 

The richness in hsp.moglobin simultaneously diminishes ; wasting 
progresses to the point of cachexia, and the appetite diminishes while 
diarrhoea appears ; swellings are noticeable about certain parts of 
the body ; and the animals, continuing to pass blood, die in a state of 
absolute exhaustion, without apparent suffering. 

This termination is the most common, unless slaughter is determined 
on, and is very different from the premature end which follows the for- 
mation of clots and obstruction of the urethra. 

Externally the patients only show feebleness, pallor of the visible 
mucous membranes, and difficulty in urination. The bunch of hair at 
the lower commissure of the vulva is always soiled with blood-stained 
urine or little clots. 

Hsematuria may cause death by exhaustion in from six weeks to two 
months, bat not infrequently it lasts for months or even years. 

Diagnosis. The diagnosis presents no difficulty when the urine 
can be examined ; but in the periods of intermittence no opinion can 
be advanced. These intermittences are so frequent that in parts of 
the country ravaged by this disease it is a usual custom, when selling, 
to grant or refuse guarantees for a longer or shorter term. 

The condition can be distinguished from parasitic hoemoglobinuria 
(piroplasmosis) or from Brou's disease (a febrile disease of rapid de- 
velopment) by simply examining the urine or blood. 

Prognosis. The prognosis is extremely grave, for, up to the pre- 
sent, no really efficacious treatment has been discovered, and although 
some animals may live for years without their lives being in any way 
endangered, this cannot possibly be foreseen, and there is no economic 
advantage in keeping them. 

Treatment. No curative treatment is known. 

It is true that iron salts, tonics, Kabel's liquid, decoctions of cer- 
tain plants, such as plantain, have been recommended, but apart 
from the fact that they are of doubtful efficacy, they cannot be used 
over long periods. All these preparations also tend to increase the 
coagulability of the blood ; but considering that the disease is beyond 
question of a parasitic character, good results cannot always be ex- 
pected of them. 



526 DISEASES OF THE BLADDER. 

Preventive treatment appears more hopeful, although even in this 
connection, the best informed appear to have considerable doubts. 
All those who have studied the question agree in recommending 
drainage of the pasturages, and their improvement by the use of 
various manures, particularly superphosphates and lime. These 
improvements alter the character of the pasture, render the soil 
healthier, and may perhaps prove suf&cient to diminish or prevent 
the local growth of the germs. Under such conditions, Boudeaud 
declares that he has seen hsematuria disappear from farms where it 
had previously been in permanent possession. It has also been re- 
commended that the affected cattle should be sent elsewhere to 
places where the disease does not exist, and experience shows that 
spontaneous recovery is more frequent under such conditions. 

It is probable that, during attacks of hgematuria in a contami- 
nated country, successive parasitic infestations occur, which would ex- 
plain the persistence with which blood is passed, a symptom which does 
not occur in a healthy country. This view, however, is still only 
an hypothesis. 



CHAPTER III. 
DISEASES OF THE KIDNEYS. 

CONGESTION OF THE KIDNEYS. 

Congestion of the kidneys is not a morbid condition in the strict 
sense of the term, for it is merely the forerunner of nephritis caused by 
infectious diseases or intoxications (primary active congestions) or the 
final consequence of other diseases, such as diseases of the heart or 
liver, mechanical compression of the vena cava or renal veins (secon- 
dary passive congestion, cardiac kidney). 

Nevertheless, under certain circumstances the develoj)ment of ne- 
phritis may be arrested at the primary congestive stage, and it is only 
then that an opportunity occurs of studying it as a definite complaint. 

Causation. All infections accompanied by lesions of the kidneys, 
and these are numerous (gangrenous coryza, anthrax, parasitic haemo- 
giobinuria), produce congestion of the kidneys. 

Cold also acts directly under certain conditions, as do large doses of 
diuretics, irritant foods the principles of which are eliminated through 
the urine (fermenting or putrid sugar-pulp, for example), and foods rich 
in resins, essential oils, various giucosides, tannin, etc. (young shoots of 
trees during the spring-time). 

Symptoms. The symptoms are difficult to define accurately, and the 
diagnosis can only be arrived at with the aid of the history. 

Eenal congestion produces pain, indicated by dull colic and repeated 
and ineffectual attempts to urinate, suggesting acute cystitis. The 
patients lose appetite, and present all the general symptoms of marked 
visceral inflammation, viz., fever, acceleration of breathing, somewhat 
tumultuous action of the heart, etc. 

External or internal ex animation of the kidneys reveals abnormal 
sensitiveness. The urine is of a dark or bright-red tint, owing to the 
presence of red blood corpuscles. These blood corpuscles are precipi- 
tated on placing the fluid in a tall glass, and can be detected, together 
with renal epithelium, by microscopic examination. 

The diagnosis is somewhat difficult, and it requires very careful 
attention to distinguish between congestion of the kidney and true 
nephritis. 



528 DISEASES OF THE KIDNEYS. 

The prognosis should always be reserved until it is certain that 
acute ne|)hritis will not ultimately develop. 

The treatment consists in removing the cause of the congestion ; 
rich foods, or foods containing irritant principles, should, therefore, be 
avoided, as also the administration of diuretics, etc. 

Otherwise, the treatment is similar to that employed in all visceral 
inflammations : bleeding to the extent of two to four quarts, according 
to the size of the animals, warm poultices to the loins and flanks, dry 
friction, mucilaginous drinks and emollient decoctions of barley or pel- 
litory. The animals should be kept in a warm place. 

In cases of passive and secondary congestion, treatment must be 
directed towards improving the condition of the organ primarily affected, 
whether it be the heart, liver, or lymphatic glands. 



ACUTE NEPHRITIS, 

The term nephritis applies to inflammation of the renal tissues. 
Clinically, two forms only can be distinguished, the acute and the 
chronic. 

As regards its pathological anatomy, the inflammation may princi- 
pally affect either the interstitial tissue or the epithelial parenchyma, a 
fact which has suggested the division of the condition into epithelial 
nephritis, interstitial nephritis, and mixed nephritis. Clinically, such 
distinctions are impossible ; and in reality all forms of nephritis are to a 
varying degree mixed, the lesions predominating in one or other of the 
constituent tissues. These lesions depend on the extent, intensity, and 
duration of the inflammatory attack, whatever the primary causes. All 
the constituent tissues of the kidney may be affected, simultaneously 
or individually : the Malpighian corpuscles, the convoluted tubules, the 
collecting tubules, or the interstitial connective tissue. 

Causation. Cold seems to be an important factor. All acute or 
chronic intoxications in which the toxic principles are eliminated by the 
kidneys, such as poisioning by cantharides, fermented beet pulp, young 
shoots of trees or toxic plants, may cause acute nephritis. 

Infectious diseases, such as gangrenous coryza, hsemoglobinuria, 
tuberculosis and post-partum infections, also play an important part, 
whether the nephritis be direct, that is to say, the result of the infecting 
agent itself, or indirect, i.e., produced by toxins generated in the body. 
In female animals gestation is an often unsuspected cause. Moussu 
believes that albuminuria is frequent during gestation, and although in 
most cases it is only of moderate degree, he thinks it is often associated 
with sub-acute nephritis, which might be aggravated by an accidental 
cause. 



ACUTE NEPHRITIS. 529 

Many forms of nephritis are overlooked in consequence of their slight 
character. 

Symptoms. The early symptoms are similar to those of congestion 
of the kidney, viz., dall colic, excessive sensitiveness over the region of 
the loins, passage of pink urine, loss of appetite, and fever. At a later 
stage, in cases of acute nephritis due to cold, the animal stands with the 
limbs close together and remains stationary, arching the loins and back, 
which are held stifHy. The animal obstinately refuses to move in con- 
sequence of the pain produced by so doing. 

The general condition becomes grave, respiration is rapid, the pulse 
frequent, the artery tense, the muzzle dry, the accessible mucous mem- 
branes are injected, and appetite is almost entirely lost. 

Urine is frequently passed, but the act causes pain, and the quan- 
tity is small. Absolute anuria is rare, and does not last long. 

The urine is generally sanguinolent, at least at first, but to a very 
varying extent. It is always albuminous, the quantity of albumen 
varying enormously, and on microscopic examination, is usually found 
to contain red and white blood corpuscles, epithelium from the kidney 
hyaline or epithelial cylinders, and, towards the end, pus corpuscles. 

(Edema or anasarca, though common in mankind, does not occur in a 
very marked form, except in intense acute nephritis. Ej)istaxis is also rare. 

Diagnosis. The diagnosis requires some care, because unless the 
urine be examined the symptoms might lead to error. Nevertheless, it 
is always possible to distinguish between this condition and hsematuria 
or accidental renal haemorrhage. 

Prognosis. The prognosis is grave, because absolute recovery is 
rare, and because the condition is very apt to become chronic. 

The degree of anuria and the respiratory difficulty are of great 
service in confirming the prognosis. As soon as urine is freely passed 
the prognosis becomes more favourable. 

Treatment. Among the most effective methods of treatment must 
be included bleeding, which always produces some improvement. Dry 
friction over the kidneys and flanks, hot moist ajDplications, and the 
application of a sheep- skin to the loins are also of service. Internally, 
mucilaginous drinks, diuretic decoctions and milk give the best results. 
The proportion of albumen rapidly diminishes, dysuria becomes less 
marked, urine is passed in greater quantities, and in from eight to ten 
days all the alarming symptoms disappear. Bicarbonate of soda may 
then be given for a fortnight. 

In very grave cases camphor, bromide of camphor, injections of 
camphorated oil (1 to 2J drachms internally, or 1 to 1^ drachms in 
subcutaneous injections) give excellent results in modifying the pain and 
moderating the inflammation. 

D.C. M M 



530 DISEASES OF THE KIDNEYS. 

From ^ to 1 drachm of digitalis in powder, or better still an injection 
of from 5 milligrammes to 1 centigramme of digitaline may also be given 
when dyspnoea is very great and is accompanied by anasarca. Medicines 
such as oil of tm'pentine and considerable doses of nitrate of potash, 
however, are contra-indicated. 



CHRONIC NEPHRITIS 

True chronic nephritis, i.e., a condition strictly limited to the renal 
tissue, and unaccompanied by pyelitis, is still little known among our 
domestic animals. The symptoms characterising it have not always 
been carefully noted, and the diagnosis is very often uncertain. Never- 
theless, one of the most common forms has been carefully studied by 
Seuffert, viz., chronic hypertrophic nephritis. 

Causation. Chronic nephritis is the common sequel to the acute 
forms, whatever their origin, but it may also occur primarily from 
repeated chills produced by such conditions as exposure to heavy con- 
tinued rain when at grass, chills contracted during cold nights and 
the great variations in temperature in spring and autumn. The con- 
ditions, however, thus produced are rather of the nature of subacute 
nephritis than of chronic nephritis, properly so called. 

These forms of chronic nephritis may also occur primarily in con 
sequence of chronic hepatic lesions with pressure on the posterior vena 
cava, producing blood stasis in the kidneys. Finally, they may repre- 
sent the delayed effects of slight lesions which have escaped notice and 
have developed during grave diseases or as a consequence of repeated 
gestation. 

From the anatomico-pathological standpoint, the only conditions 
hitherto recognised are the chronic hypertrophic forms of nephritis 
(large, white sclerotic kidney with lardaceous degeneration and some- 
times marbling). This is probably because the animals are slaughtered 
as soon as they suffer in condition, but if they were kept long enough 
they would undoubtedly suffer also from the atrophic chronic forms of 
nephritis found in man and in the dog. In the case of man observation 
has shown that these two forms only represent different stages in the 
development of one disease, the large, hypertrophied kidney of the early 
stages afterwards undergoing marked progressive atrophy. 

The symptoms are at first so vague that diagnosis would be 
impossible on a single examination. Seuffert states that the condition 
develops as follows : — 

The first sign, loss of appetite, is soon followed by constipation and 
dull colic, due to congestion of the kidney ; the pain is often so great 
as to cause intermittent groaning. 



HYDRO-NEPHROSIS. 531 

The urine passed is always turbid, and sometimes blood-stained, but 
this staining rarely lasts longer than a week. The urine then gradually 
resumes its normal appearance, is passed in small quantities, and con- 
tains more or less albumen. The yield of milk markedly and progres- 
sively diminishes. 

If treatment is resorted to at this stage laxatives and diuretics 
appear to effect a real improvement. Unfortunately, however, the 
ap^Darent improvement is but temjDorary ; the kidneys become hyper- 
trophied, and the right soon occupies the whole of the sublumbar 
space, its margin extending as far as the extremity of the transverse 
processes near the anterior angle of the hollow of the flank. 

This hypertrophy and the extreme sensitiveness can be detected 
by external palpation. Internal examination confirms the facts so 
observed as regards both the kidneys. 

The patients eat little and become thin, whatever treatment be 
adopted. They progressively waste, and die after some months in a 
state of marasmus, exhausted and intoxicated. 

It is very probable that the digestive disturbances are complicated 
by respiratory and cardiac trouble, as in man and the dog ; but neither 
cardiac nor uraemic disease of the kidney has been recorded. 

Diagnosis. When the urine is analysed the diagnosis becomes com- 
paratively easy. Persistent albuminuria and hypertrophy of the kidneys 
during the early stages are significant indications. There can be little 
hesitation except in so far as pyelo-nephritis and hydro-nephrosis are 
concerned, but the conditions are distinguished by the character of the 
urine in the two latter cases, together with the condition of the pelvis 
of the kidney, and of the ureters. 

Prognosis. The prognosis is grave, and Seuffert believes that re- 
covery never occurs. This is also true, generally speaking, as regards 
all forms of chronic nephritis. 

■ Treatment. As the disease must be regarded as incurable there is 
really no justification for treatment. Nevertheless, if for special reasons 
the owner wishes to keep the animals for a certain time, as in the 
case of a cow near its time of calving, recourse may be had to the 
internal treatment suggested in acute nephritis, viz., mucilaginous 
drinks, diuretic infusions, milk, bicarbonate of soda, stimulating 
applications to the loins, etc. , 

HYDRO-NEPHROSIS. 

Hydro-nephrosis, i.e., retention of urine in the pelvis of the kidney 
and in the collecting and secreting tubules, is a somewhat common 
malady of the bovine species. It is usually confined to one kidney. 

M M 2 



582 



DISEASES OF THE KIDNEYS. 



Causation Anything which obstructs the discharge of urine through 
the ureters may cause hydro-nephrosis. Thus, vesical tumours pressing 
on the orifices of the ureters, calcuH which have become fixed in them, 
torsion or "kinking" of the ureters, may bring about hydro-nephrosis. 
The urine secreted by the kidney being unable to escape, accumulates 
in the pelvis of the kidney, in the ureter, and uriniferous tubules, 
producing dull colic, which escapes observation, or the exact cause of 
which is not discovered, because the second kidney vicariously acts for 
the one affected, and urination continues regularly. Secretion continu- 
ing in spite of the ob- 
struction, that portion of 
the ureter above the ob- 
structed point, together 
with the pelvis and 
the uriniferous tubules, 
l^?^^^ gradually becomes di- 

lated, until the whole 
mass of the kidney is 
hypertrophied. 

The ureter some- 
times becomes enlarged 
I '.^^m^ i^^^^ \ ^ to the size of a man's 



arm, the kidney double, 
treble, or quadruple its 
normal side : the inter- 
lobular divisions are 
lost, and each circum- 
scribed lobule soon 
forms a cystic cavity 
varying in size. The 
pressure due to the accumulated urine causes the renal tissue, first the 
medullary substance and afterwards the peripheral zone, to undergo 
atrophy. 

The kidney is represented by a vast cystic cavity, and the lobules 
by culs-de-sac ; the cortical layer may become atrophied to such a 
degree as to form merely a fibrous sheath, the primary constituent 
elements of which are difficult to discover. From 20 to 40 pints of 
liquid may sometimes be found in the cystic kidney. 

Diagnosis. The condition is rarely diagnosed, because, as one of the 

kidneys continues to act, no acute disturbance follows. Only in cases 

where the cystic kidney projects into the flank are suspicions aroused. 

Examination per rectum will then permit of the diagnosis being made. 

Prognosis. Hydro-nephrosis being, as a rule, unilateral, the 




Fig. 228. — Hydro-nephrosis of the kidney. 



INFECTIOUS P^ELO-NEPHRITIS. 



533 



prognosis is not very grave as regards immediate danger. As the 
condition is hopeless, however, the lesions being irreparable, the 
animal should be prepared for slaughter. 

Treatment. Practically there is no treatment. Puncture of the 
cystic cavity or even the removal of the hydro-nephrotic kidney cer- 
tainly suggests itself, but, as such operations are usually opposed to 
the interests of the owner, they are rarely or never practised. 

INFECTIOUS PYELO'NEPHRITIS. 

The term " infectious pyelo-nephritis " describes an inflammation 
which may involve any portion of the mucous membrane of the 




Fig. 229. — Section of a kidney affected with hydro-nephrosis. The gland substance 
is almost entirely atrophied, and each lobule shows marked dilatation. 



urinary tract, and which is produced by a special bacillus. As a 
rule, this inflammation commences in the mucous membrane of the 
calices and pelvis (pyelitis). It afterwards extends into the depths 
of the uriniferous canaliculi (nephritis), but in grave and old-stand- 
ing cases the mucous membrane of the ureters and the bladder may 
also be affected. The disease had long been known in France 
(Eossignol, 1848). It was afterwards described in Germany (Siedam- 
grotski, 1875; Pflug, 1876), in Switzerland (Hess, 1888), and also in 
France (Lucet, 1892; Masselin and Porcher, 1895). 

Causation. Female animals are more frequently affected than 
males, because the lesions are produced by an ascending infection, 
originating very frequently in genital infection after delivery. Never- 



534 DISEASES OV THE KIDNEYS. 

theless, calculus formation is also an important factor in producing 
the disease. 

Many different agents are capable of producing pyelo-nephritis. 
HofHich in 1891 described a bacillus about 2 to 3 micromillimetres 
in length, which stained readily with aniline colours and with Gram 
solution. Lucet in 1892 found a short bacillus which did not stain 
with Gram, and later another thin bacillus which did. Kitt has 
described cocci, but no other organisms. Masselin and Porcher dis- 
covered a cocco-bacillus which stained with Gram and reproduced 
the disease in an animal lent by Moussu, after a single intra-vesical 
injection of the culture. Cadeac has met with staphylococci, and 
Moussu has discovered various bacilli, some resembling the colon 
bacillus, and pyogenic streptococci. 

There is no doubt that many different organisms may produce 
pyelo-nephritis by ascending infection. The most common seem to 
be forms of paracoli, such as the Bacillus itrece. Moussu nevertheless 
believes that Hof!lich's bacillus, which was rediscovered by Porcher, is 
that w^hich produces typical pyelo-nephritis. It grows in the bladder 
without producing cystitis, and is succeeded by an ascending infec- 
tion of the ureters without causing primary ureteritis, the local inflam- 
mation occurring chiefly, it would seem, in the pelvis and the kidney. 
All the other organisms which Moussu has tested have caused lesions 
of cystitis and of ureteritis, together with those of pyelo-nephritis. 

In these latter cases the pyelo-nephritis assumes the acute form, 
and is accompanied not infrequently by cellulitis and abscess forma- 
tion in the tissue around the kidney. 

Symptoms. Pyelo-nephritis develops in one of two principal forms, 
the slow chronic form, which is the most frequent, or an acute or 
subacute form, much more rapid in its development. 

The chronic form for a time escapes notice. There is no doubt 
that at first some general disturbance occurs, such as diminution of 
appetite, disturbed nutrition, unhealthy general appearance, staring 
of the coat, tightness of the hide, wasting, etc., but such symptoms 
are in no wise characteristic, being found in all grave diseases. 

The signs only become really significant from the clinical standpoint 
when the urine appears modified in character, and such modification 
does not occur until the pelvis of the kidney and the kidneys them- 
selves are already gravely diseased. 

The urine is then turbid, of a brownish colour, and charged with 
sediment, filaments of mucin, pus corpuscles, and earthy phosphates. 
On analysis it is found to contain more or less albumen. 

At a late stage it may even become glairy, blood-stained, or of 
the colour of blood, and when the pelvis or the calices of the kidney 



iNFECTiOUS PYELO-NEPHRITiS. 



o35 




Fig. 230.— Pyelo-nephritis with hgemorrliagic pyo-nephrosis of one side. One ureter 
is dilated and blocked with a blood clot. 



536 DISEASES OF THE KIDNEYS. 

are ulcerated may, on standing, deposit considerable quantities of red 
blood corpuscles. 

Exposed to the air, the urine rapidly assumes a brown tint and 
smells strongly of ammonia. 

Percussion of the loins in the region of the kidneys causes pain, as 
does external palpation by the flank. On rectal examination at this 
period the ureters are found to be distended and hard, and they give 
the imj)ression of rigid or bosselated fibrous cords, sometimes as large 
as a child's arm. The corresponding kidney, often both kidneys, are 
enlarged, sometimes to double or treble their normal volume, and are 
painful. on pressure and fluctuating, at least in the region of the pelvis. 
On vaginal examination the meatus urinarius is usually found to be in- 
flamed, rough and turgid. 

In this condition the animals rapidly lose flesh, the appetite becomes 
irregular, the general condition gradually gets worse, and they die as a 
result of continued uro-septic fever or ursemic troubles. 

The acute form takes a much more rapid course, with fever, more 
marked general disturbance, acceleration of pulse and breathing, the pas- 
sage of turbid and sometimes purulent urine with a strong ammoniacal 
smell. Pyo-nephrosis is the most frequent and characteristic end. Ordi- 
nary chronic pyelo-nephritis may also occur in these cases, and the acute 
course may be determined simply by accidental ascending infections. 

Diagnosis. During the early stages diagnosis is extremely difficult, 
unless a careful examination of the urine be made. Afterwards it becomes 
easy, the appearance of the urine and the indications furnished by 
rectal exploration being perfectly characteristic. In very exceptional 
cases there may be some doubt, as where the urine remains normal, in 
spite of hydro-nephrosis, or where there is old-standing haematuria or 
renal tuberculosis. In simple haematuria the lesions are confined to the 
bladder and ureters, the kidneys not being affected, and in renal tuber- 
culosis the diagnosis can always be confirmed by the use of tuberculin. 

Prognosis. The prognosis is extremely grave, for the lesions pro- 
duced are irreparable, and, moreover, local intervention is impossible. 

Treatment. There is no curative treatment. All that is possible is 
palliative treatment with the object of facilitating the function of the 
kidney and of disinfecting the urinary passages by administering anti- 
septic substances which are excreted by the kidney. It is not possible, 
however, to administer active drugs of this kind {e.g., combinations of 
carbolic acid). As the kidney acts badly it soon ceases to eliminate such 
substances, and the condition would not be improved, but aggravated. 

Benzoate of soda in doses of 2 to 2^ drachms per day dissolved in 
diuretic liquids is the most useful drug, and sometimes holds the disease 
in check for a sufficient time to allow of the animals beino^ fattened. 



StrPPURATlVE NEPHRITIS AND PERINEPHRtTlS. 537 

Treatment also comprises certain prophylactic precautions. As the 
infection which produces pyelo-nephritis originates in the genital tract, 
it is desirable to protect all animals in a receptive condition (those about 
to calve or having recently calved) from infection ; hence, when the 
disease is detected in a cow-shed, the patients should be isolated, and 
the shed thoroughly disinfected. 

SUPPURATIVE NEPHRITIS AND PERINEPHRITIS. 

Suppuration of the kidney may occur under two conditions. In the 
majority of cases such suppuration occurs as a complication of pyelo- 
nephritis ; less frequently it is the consequence of infection from within 
or infection of adjacent parts, leading to the formation of an abscess. 

When it results from an ascending infection the kidney becomes 
swollen, congested and inflamed, and soon displays localised minute 
haemorrhages. Pus then forms within the calices, in the large straight 
tubes, and diffuse suppuration invades all the uriniferous tubules. The 
enlarged kidney is yellowish, firm under the knife, and when sections are 
com23ressed pus exudes from the openings of the tubular canaliculi. 

When suppurative nephritis has resulted from accidental infection 
of internal origin, an abscess is found to have produced more or less 
extensive atrophy of a portion of the kidney while not affecting the rest 
of the organ. 

It is only in those favourable cases where the renal abscess opens 
into the pelvis that suppuration may invade the whole of the kidney, 
producing diffuse suppurative nephritis by secondary infection of the 
uriniferous tubules. Such complications are rare. Usually the abscess 
empties through the pelvis, and recovery may occur. 

More frequently suppurative pyelo-nephritis develops, together with 
ureteritis, cystitis, dilatation of the ureters, dilatation of the pelvis of 
the kidney, and dilatation of the collecting tubules of the pyramids, the 
final stage resembling the lesions of pyo-nephrosis. 

Perinephritis and perinephritic cellulitis, i.e., inflammation with or 
without abscess formation in the connective tissue and adipose layer 
surrounding the kidney, always occur in cases of suppurative nephritis 
or pyelo-nephritis. Such inflammations may also, in exceptional cases, 
follow direct mechanical injury, but they almost invariably represent 
complications, the organisms infecting the kidney passing through the 
tissues and the layer of fibrous tissue, or extending by the lymphatic 
paths, finally attaining the fatty tissue surrounding the kidney and there 
undergoing multiplication. The fatty tissue is infiltrated with reddish 
serosity, is inflamed, and may become the seat of large abscesses com- 
municating with or separate from the abscesses of the kidney itself. 



588 DISEAI^ES OF THE KIDNEYS. 

Symptoms. Suppurative nephritis is characterised by fever, losg 
of appetite, arrest of rumination, and frequent attempts to urinate. 
These attempts are painful, are accompanied by groaning, and end in 
the j)assage of an insignificant quantity of blood-stained and purulent 
urine. 

Palpation, more especially palpation of the right flank, percussion 
over the region of the loins, and examination of the kidneys through the 
rectum are painful. Wasting is rapid. 

If the suppurative nephritis develops rapidly, and particularly if it be 
accompanied by perinephritis, the patients refuse to rise and appear to 
be suffering from paraplegia, although not really so, both sensation and 
motor power persisting in a greater or less degree. Probably the condi- 
tion is accomipanied by reflex pain and irritation of the nerve-trunks of 
the lumbo-pubic plexus. 

On the other hand, when suppurative nephritis tends to develop 
slowly and assume a chronic form, lesions of pyo-nephrosis gradually 




Fig. 231. — Leaf lard around kidney of pig. 

develop, and are identical in appearance with those of hydro-nephrosis, 
except that the ureters, the pelvis and the dilatations corresponding to 
the lobules, are filled with pus. 

Diagnosis. The diagnosis is not very difficult. The urinary trouble 
and the composition of the urine itself always arouse suspicion. The 
diagnosis is confirmed by careful and methodical examination ijer rectum : 
the inflammation of the fatty tissue surrounding the kidney can usually 
be detected. 

Prognosis. The prognosis is extremely grave, and almost always 
fatal, particularly in cases of diffuse nephritis. 

Treatment. No curative treatment can be absolutely relied on. 
Treatment, if attempted, is limited to the methods suggested for pyelo- 
nephritis. Mucilaginous, emollient, and diuretic drinks, and daily doses 
of 2 to 3 drachms of benzoate of soda given in the drinking water, cause 
some improvement. 



THE KIDNEY WORM (SCLEIIOSTOMA PINGUICOLA) OF SWINE. 539 



Stimulation of the region of the 
loins also undoubtedly has a favour- 
able effect, and should always be 
practised, particularly where peri- 
nephritis is developing. It may check 
the course of the disease and pre- 
vent the formation of abscesses. On 
slaughtering animals suffering as 
above described the layer of tissue 
surrounding the kidney is found to 
be lardaceous and fibro-fatty. 

Any treatment through the bladder 
is contra-indicated, for even the pas- 
sage of a catheter may cause severe 
injury of the urethra or the vesical 
mucous membrane and produce a 
fatal aggravation. 

If these conditions are diagnosed 
early, while the function of the kidney 
is more or less preserved, and if the 
animal is still in good condition, it 
should be slaughtered. 

THE KIDNEY WORM (SCLEROS- 
TOMA PINGUICOLA) OF SWINE.* 

In the United States of America a 
worm is frequently found in the fat 
surrounding the kidneys of pigs, and 
is supposed by farmers to be the cause 
of paralysis of the hind limbs. 

This so-called kidney worm of 
hogs {Sclerostoma invguicola) should 
not be confounded with the kidney 

* From Keport of the U.S.A. Bureau 
of Animal Industry, 1899, p. 612. (Louise 
Taylor.) 



Fig. 232. — Sclerostoma jpinguicola. External 
view of female, a, Male, natural size ; 6, fe- 
male, natural size ; c, mouth ; d, buccal 
cavity ; e, oesophagus ; /, intestine ; g, anus ; li, 
genital opening ; i, genital tract ; A*, cephalic 
gland. (Louise Taylor, Annual Eeport, Bureau 
of Animal Industry, 1899, p. 614.) 




540 



DISEASES OF THE KIDNEYS. 



worm (Dioctoj^hyme viscerale) of dogs and man. Both of these parasites 
belong to the same zoological family (Strongylidae), but to different sub- 
families and genera. The kidney worm of dogs grows to a length of 
1 to 3 feet. The kidney worm of hogs is much smaller, attaining at 
most something less than 2 inches in length. 

The body of the worm is plump, mottled in color — red, yellow, white, 
black- — according to the organs visible beneath. The average female is 
about 37 mm. and the average male 32 mm. in length. The worms 
seem to occur in pairs, usually in cysts or canals ; thus, upon the exami- 
nation of two kidneys with their surrounding fat, fifteen specimens were 





Fig. 238. — Embryos of Sclerostoma pinguicola. (Louise Taylor, Annual 
Eeport, U.S.A. Bureau of Animal Industry, 1899, p. 634.) 



found, seven males and eight females. The connective tissue layers 
between the fat were found to be the most general seat of infection, and 
the cysts were numerous and closely packed together. Although a cyst 
usually contained two worms, a male and a female, sometimes three were 
found together, two females and one male, or just as often one female 
and two males. The cysts contained pus, which bathed the parasites, 
and in which were thousands of eggs in the segmentation stage. Still, 



THE KIDNEY WORM (SCLEROSTOMA PINGUICOLA) OF SWINE. 541 

otber cj^sts, upon being cut into, were found without parasites and in a 
necrotic condition. 

It will be noticed that Sclerostoma inngidcola is colloquially known as 
the kidney worm. In no case, however, has Miss Taylor found it in the 
kidney substance, but only in the tissue surrounding this organ ; the 
lard appears to be its normal habitat, at least. 

Just how the eggs leave the kidney fat or enter the bodies of fresh 
hogs has not been demonstrated, but it does not seem unreasonable to 
suppose that they eventually find their way out with the urine. Indeed, 
Dean reports eggs found in the urine. From analogy one is led to 
believe that no intermediate host is required, but that in all probabilit}- 
the embryos develop for a short time in water, casting several skins, 
and they eventually gain access to the hogs either through contaminated 
drinking water or food. 

Because of the hog's habits, it is difficult to see any practical measures 
which can be adopted to prevent infection. Feeding from troughs 
and supplying plenty of pure drinking water will decrease but not 
exclude the disease. Leuckart's advice to the Germans, " Swine should 
be kept in a less swine-like manner," holds good in all countries and in 
connection with all diseases. It is equally impossible to suggest prac- 
tical methods of treatment. This is all the more true because it seems 
probable that a number of distinct complaints are popularly grouped 
together by the farmer as kidney-worm disease. 



CHAPTER IV 
GENITAL APPARATUS. 

Semiology. The examination of the genital apparatus properly so 
called is easy in animals of large size, whether male or female, but is 
more delicate and difficult, and is sometimes partially impossible, in 
small creatures. 

In male animals it comprises the examination of the testicles by 
inspection and palpation, of the vas deferens, and of the intra-pelvic 
genital organs (vesiculae seminales, prostate, etc.)- 

Inspection and palpation of the scrotum reveals hypertrophy, 
atrophy, oedematous or sanguineous infiltrations, inflammation of the 
tunica vaginalis, and tumours of the testicle. Intra-pelvic examina- 
tion partly covers the same ground as examination of the pelvic 
portion of the urethra, and, provided the anatomical relationships of 
the different organs encountered are known, there is no difficulty in 
detecting the position of possible lesions (Fig. 226). 

In small male animals, such as he-goats and rams, rectal exploration 
is confined to the use of one or two fingers. 

In female animals examination comprises inspection, intra-vaginal 
examination, and rectal examination. 

Inspection reveals lesions of the vulva and clitoris. 

Vaginal examination with the hand establishes the condition of the 
walls of the vagina, the neck of the uterus, and the vaginal culs-de-sac. 

If a lesion is detected, its character can easily be ascertained by 
means of a speculum, which exposes the base of the vagina, the promi- 
nence formed by the uterus, or any particular part of the vagina itself. 
Examination with the speculum is the only useful method in young 
female animals, heifers in particular, on account of the narrowness 
of the genital tract. 

In small female animals, such as she-goats, ewes and sows, the 
fingers alone can be employed. 

As regards examination of the uterus, the direct method gives little 
exact information, and examination by the rectum is to be preferred. 
By passing the arm into the rectum and gently pressing downwards 
towards the base of the pelvis, the hand can be brought in contact 



VAGINITIS. 



543 



with the body of the uterus, which can be moved and displaced from 
right to left ; the horns of the uterus can be felt and followed from 
the body of the uterus as far as the Fallopian tubes and the ovaries. 
By this means the state of the uterus, its degree of sensitiveness and 
mobility, as well as the state of the Fallopian tubes and of the ovaries, 
can all be ascertained. The examination also reveals the existence or 





c.u 



i 






Fig. 234. — Genital organs in a cow, showing the anatomical relations. R, Rectum ; 
Gr, meso-rectal lymphatic glands ; U, m^eter ; LL, broad ligament ; Va, vagina ; 
V, bladder ; Cu, uterine cornu; O, ovary ; F, Fallopian tube. 



non-existence of gestation, during which the uterus becomes hyper- 
trophied and is displaced in a forward direction towards the right 
flank, at the same time descending in front from the base of the 
pelvis over the abdominal wall and under the mass of the intestinal 
convolutions. 

VAGINITIS, 

Inflammation of the vaginal conduit may be primary or secondary. 
It usually follows difficult parturition, but may occur under various 



544 GENITAL APPARATUS. 

circumstances. From the clinical standpoint three varieties are dis- 
tinguished : simple or contagious acute vaginitis ; croupal vaginitis ; 
and chronic vaginitis. 

ACUTE VAGINITIS. 

Causation. Deep-seated genital injuries leading to metritis, exces- 
sive and prolonged strains due to painful labours, accidental injuries 
caused by obstetrical operations, etc., are followed by more or less 
acute vaginitis. 

Suppurative inflammation of Gartner's canals, irritant and caustic 
injections, and foreign bodies likewise cause local irritation, which may 
become complicated by infection and eventually produce vaginitis. The 
infective organisms may be numerous and varied. 

Symptoms. The vagina being closed to external inspection, the 
symptoms are not very apparent. At first, acute vaginitis is sug- 
gested by swelling of the vulva, pruritus, and dysuria. The lips 
of the vulva are oedematous, injected, sensitive and of a brownish- 
red or violet-red colour on the internal surface. Sometimes they 
are excoriated and torn. 

The period of full development is accompanied by the escape from 
the vulva of a serous, mucous, muco-purulent or purulent discharge 
of varying odour. Urination is painful and defsecation difficult. Ex- 
amination of the vagina by means of a speculum shows the mucous 
membrane to be excoriated, ultra-sensitive, ulcerating or suppurating at 
certain points. The parts are hot. 

The general symptoms are little marked, and without importance. 
The usual termination consists either in recovery, which may be spon- 
taneous, or in passage to the chronic form. 

The diagnosis is easy, and the prognosis favourable, provided the 
vaginitis has not been caused by severe mechanical injuries, capable 
of setting up cellulitis or the formation of deep abscesses of the pelvis. 

Treatment. One of the principal reasons why vaginitis persists is 
the retention of morbid products in the vaginal culs-de-sac. Treat- 
ment ought therefore to aim chiefly at removing these by soothing, 
astringent, and antiseptic injections. Soothing injections should first 
be tried. They consist of lukewarm water at body temperature, 
decoctions of black-cherry bark, poppy-heads, linseed, etc. After a 
few days, when the excessive sensibility has disappeared, antiseptic 
and astringent solutions may be used, such as crystallised alum, 150 
grains to the pint ; sulphate of zinc, 75 grains to the pint ; carbolic 
acid, lysol, cresyl, etc., 150 grains to the pint. 

Injections of permanganate of potash of the strength of 150 grains 
to the pint and of solutions of iodine at a strength of 1 in 2,000 are 



CRotJPAL Vaginitis. 545 

more active, but require more careful handling. Hydroxyl diluted 
with from 3 to 5 parts of water is also of great efficacy. Strong 
solutions should never be used, because they cause irritation and ex- 
pulsive efforts. 

All these injections may be made without difficulty by passing a 
simple perforated drainage tube to the end of the vagina, and con- 
necting it wdth a syringe, or, better, with a small cistern hung from 
the wall, which allows the required pressure to be obtained. 

When there are deep and severe wounds, the parts should be washed 
out once or twice daily and the vagina should be packed with surgical 
wool and iodoform gauze. The septic liquids are absorbed by the 
dressing, which acts continuously. This dressing is renewed until re- 
covery takes place. 

CONTAGIOUS VAGINITIS. 

During the past few years certain observers have described a disease 
which has been termed "contagious vaginitis," in consequence of the 
facility with w^hich it is transmitted. 

This vaginitis may be transmitted by copulation, the bulls then 
serving as propagators of the disease. The bulls themselves are usually 
affected wdth balanitis. 

The causative agent of the disease is unknown. 

This contagious vaginitis is characterised by all the symptoms of 
acute vaginitis, and it is only from the fact of its appearing in all the 
animals served by one bull that its contagious character is established. 
A short time after service the vulva appears swollen and extremely 
sensitive ; at the same time general disturbance appears, viz., diminu- 
tion of appetite and of milk secretion, slackening of rumination, etc. 

Vaginal exploration, which is somewhat difficult, reveals a papulo- 
vesicular eruption, accompanied by a muco-purulent discharge. 

This vaginitis is easy to diagnose. It may disappear spontaneously, 
and the treatment differs in no respect from that of ordinary acute 
vaginitis. 

CROUPAL VAGINITIS. 

Croupal vaginitis is a form of acute vaginitis, from which it is dis- 
tinguished by the formation of false membranes resembling those of 
diphtheria over the whole of the vaginal mucous membrane. 

It was described by Baumeister. Moussu has only seen one case, 
and that at a period w^hich rendered recovery out of the question. 

Symptoms. The external symptoms are those of acute vaginitis, 
with greyish, foetid, purulent or sanguinolent discharge. On examina- 
tion, the mucous membrane is found to be covered with yellowish, 
greyish false membranes, and with vegetations of a greyish, dirty, 
D.c. N N 



546 GENITAL APPARATUS. 

verrucous appearance. The entire extent of the vagmal mucOuS 
membrane may be attacked, together with the neck of the uterus. In 
Moussu's case the uterus itself was entirely invaded. 

These false membranes and vegetations are very adherent, and 
bleed freely at the slightest touch. They are apt to extend by degrees. 

The cause of this infection has not yet been determined. It appears 
to obtain access to the parts during parturition, and develops insidiously 
for a week or two, when widespread lesions have already formed. 

The diagnosis is extremely easy. 

The prognosis is grave, for the lesions have a tendency to extend 
towards neighbouring organs. Moreover, the general health is severely, 
affected ; there is rapid wasting, loss of appetite, and continued fever 
and death occurs from exhaustion, intoxication, and possibly infection. 

Treatment. The treatment suggested for the ordinary acute forms 
appears to be useless in this condition. The new membranes show 
too many folds, depressions, and accidental culs-de-sac for simple in- 
jections to have any real effect. Better results might be expected 
from packing with antiseptic gauze or from the use of antiseptic 
ointments applied after washing out the cavity with permanganate 
of potash solution or hydroxyl. 

Curettage, followed by the use of gauze dressings, might also 
be tried; considerable difficulty must necessarily be anticipated in 
operating in a cavity which has become inextensible and partly filled 
with vegetations and false membranes. 



CHRONIC VAGINITIS. 

Chronic vaginitis usually represents the last stage of some form of 
acute vaginitis, though it occasionally develops in a slow and progres- 
sive fashion as a primary condition in consequence of some deep-seated 
genital lesion. There is usually a constant discharge of irritant material. 

The symptoms are not very striking, and are purely local. 

Externally all that can be detected is a continuous or, much more 
frequently, an intermittent muco-purulent discharge from the vulva, 
which occurs only on urination, defsecation, coughing, etc. 

Locally, examination with a speculum discloses the fact that the 
mucous membrane is of a greyish colour, thickened, less yielding 
than usual, and in places sclerosed. The entire thickness of the 
mucous membrane is affected, as also at times the muscular tissue, 
chronic irritation having caused sclerosis. 

The diagnosis is very simple, and the prognosis of no particular 
gravity, because the animals can always be fattened. The condition 
is only grave as regards animals intended for breeding. 



SEPTIC METRITIS. 547 

Treatment is often very successful, but, as in all chronic dis- 
eases, it extends over a considerable time. Practically it is not often 
attempted. It does not differ greatly from that of ordinary acute vagi- 
nitis, but the best results seem to follow the use of astringents. 

METRITIS. 

Infectious or traumatic diseases of the uterus are of the greatest 
importance in bovine pathology, both on account of their frequency 
and gravity. They comprise septic metritis, acute metritis, and chronic 
metritis. 

SEPTIC METRITIS. 

Septic metritis is also termed "metro-peritonitis" and "parturient 
sei3tic8emia." It may be compared with puerperal fever in woman. 

These terms are sufficiently explicit to indicate that if at first the 
metritis is typical it frequently becomes complicated wdth peritonitis, 
and too often also with true septicaemia. 

Causation. The disease only appears after parturition or abortion, 
and during the few days immediately succeeding delivery. Parturition 
may occur spontaneously in a perfectly regular and easy manner, and 
nevertheless be followed by fatal metritis as a consequence of infection. 
Usually the labour has been difficult, and the after-birth, or portions 
of the foetal membranes, have been retained. Septic metritis then 
develops in consequence of their putrefaction. 

Infection with micro-organisms is therefore the essential cause, and 
the only one of importance. None of the conditions formerly invoked 
can do more than favour or check the course of this infection. 

Moreover, the subsequent complications are entirely due to the 
special character of the infective agent. 

These infective agents may be of various descriptions. They have 
been the subject of numerous investigations, on account of the gravity 
of puerperal fever in woman. Pasteur, Colin, Chauveau and Doleris 
were the first to take up this question. In veterinary medicine several 
inquiries have been instituted, but a great deal remains to be done. 
The most frequent agents are varieties of streptococci, of the colon 
bacillus, and of putrefactive bacteria. 

Septic metritis may occasionally be purely accidental and only 
affect one animal, but infection of stables by a primary case is an 
obvious cause of propagation. Moussu has seen six animals succes- 
sively die of septic metritis in one year, and in a stable which had 
not been disinfected after each death. 

Symptoms. The first symptoms occur between the first and fourth 
days after parturition, when the uterine mucous membrane is still 

N N 2 



548 GENITAL APPARATUS. 

tender, discharging and bleeding, and the lochial discharge is abun- 
dant. The disease rarely appears after the first week. The earliest 
symptoms are dulness, depression, loss of appetite, and general 
weakness. The animals appear exhausted, the secretion of milk is 
diminished or altogether suspended, and all the chief functions of the 
body are interfered with. 

The temperature varies in a peculiar and significant way. In some 
forms, due to infection with streptococci or to mixed infection, it rises 
to 104° or 105° Fahr. ; in others it remains stationary or falls below 
normal. It might be thought that in these latter cases, which are 
usually due to infection with the colon bacillus, the general condition 
was not grave. This, however, would be a very serious error, for in 
such cases death follows as rapidly as in the others. 

The patients, or some of them at least, have slight colic and 
peritonism when the infection extends to the peritoneal pockets at 
the entrance to the pelvis. At a later stage they appear prostrate, 
remain lying, and seem to be suffering from paralysis of the hind 
quarters. 

None of these general symptoms are in themselves significant, and 
to appreciate them at their true value the local signs must be taken 
into account. 

The external genital organs are moderately swollen, the vagina is 
infiltrated and sensitive, and is soiled by exudate of varied character. 

The neck of the uterus is sometimes prematurely contracted after 
the first or second day, constituting a troublesome complication both 
in examining the parts and in treatment. "When, however, it is dilated 
and the hand can be passed, it is found that the uterus itself is not 
contracted or is only half-contracted, and that it is filled with a 
reddish-grey liquid of putrid appearance, sometimes without smell, at 
others foetid or even putrid. 

The uterine mucous membrane is infiltrated, thickened, and ex- 
tremely fragile, ]3artially destroyed, and breaks at the slightest touch. 
The cotyledons may become loosened by necrosis, and accumulate in 
the depression formed by the gravid horn of the uterus ; otherwise 
they may be detached without difficulty. 

When the neck of the uterus is prematurely contracted direct ex- 
ploration gives no result, but rectal examination reveals a much en- 
larged uterus, filled with liquid or distended with putrid gas. 

If, however, the after-birth has not come away, fragments of foetal 
membranes may be removed from the deeper portions of the uterus 
or the surface of the cotyledons. 

Death is inevitable unless treatment is early initiated. The animals 
succumb to infection produced by germs entering the vascular appa- 



SEPTIC METRITIS. 549 

ratus. When the mfection extends by contiguity of tissue to the 
peritoneal cavity the immediate causes of death are infection and in- 
toxication. In cases where the infection remains locahsed within the 
uterus the animal is poisoned by the absorption of toxins through the 
uterine mucous membrane. 

The condition may prove fatal in from four to six days in the 
cow, but in a shorter period in the goat, ewe, and bitch. 

Lesions. The uterus is excessively fragile, and can be torn at will. 
The mucous membrane in which the micro-organisms more particu- 
larly develop appears necrosed in places. Large areas are sloughing 
or ulcerated. 

The vessels are thrombosed, and extensive portions of the organ 
may be affected by true capillary phlebitis. 

The lymphatics are dilated and distended with pus in animals 
which have resisted for some days. 

If there is peritonitis, the entire floor of the abdominal cavity is 
affected, and sometimes the peritonitis is generalised. 

The lesions in the other tissues and viscera are similar to those 
found in septicaemia and in general intoxication, such as injection 
of the cai^illary system, and interstitial extravasations of blood in the 
pleura, pericardium and other tissues. 

Diagnosis. The diagnosis of septic metritis is not very difficult, 
though something more is required than simple observation of ex- 
ternal signs. From the clinical standpoint it is of no great import- 
ance to distinguish between the various forms or to determine the 
responsibility of micro-organisms for the infection. In every case the 
practitioner must utilise all the means at his disposal. 

Prognosis. The prognosis is extremely grave, and death almost 
invariably occurs when treatment is not early undertaken. 

Treatment. Treatment should be prompt and energetic. Infection 
of the genital organs being the cause of the symptoms, it is against 
this that remedies should be directed. The parts should first be 
thoroughly washed out with boiled water at the body temperature. 
A stiff drainage tube about 6 feet in length is passed to the base of 
the uterus and connected at its free end with a reservoir of liquid, 
which can be raised so as to obtain sufficient pressure. During this 
operation the animals should be placed with the front limbs higher 
than the hind. 

When the liquid injected returns perfectly clear, antiseptics may 
be employed. Strong solutions containing mercury, carbolic acid, 
lysol or creolin should be avoided, partly because of their toxic 
action, but principally because they cause irritation and violent 
expulsive efforts. 



550 GENITAL APPARATUS, 

A 25 per cent, hydroxyl solution gives surprisingly good results. 
A 1 in 2,000 iodine solution (iodine 15 grains, potassium iodide 
1 drachm, warm water 4 pints) is also of very great service. 

As the first irrigations are difficult to carry out thoroughly, it is 
often advisable to cleanse the parts directly by means of a large dis- 
infected sponge, which should be passed over the whole surface of 
the mucous membrane and into the depressions of the uterus, thus 
directly removing septic liquids. Thereafter irrigation will be easier 
and more efficacious. 

This method, however, of cleansing the parts is dangerous for the 
operator unless he takes the antiseptic precautions necessary in 
every case of delivery. 

When the neck of the uterus is prematurely contracted, the diffi- 
culties become much greater, and are sometimes insurmountable on ac- 
count of the impossibility of dilating it. It then becomes necessary to 
use metallic canulse or uterine sounds made of aluminium in order to 
pass through the neck of the uterus. Liquids can be evacuated by com- 
pressing the uterus through the wall of the rectum, but the method 
is very troublesome. 

This local treatment should be practised twice a day at least until all 
danger is over, and may be completed by the administration of diffusible 
stimulants, such as alcohol in doses of 6 to 10 ounces, acetate of 
ammonia in doses of 2 drachms, wine, cofTee, and diuretic decoctions. 
These may be given with food or drink to whatever amount is con- 
sidered necessary if the animals still retain tbeir appetite. The food 
should be light and easily digested. 

From 8 to 12 pints of physiological salt solution may be injected 
intravenously every day, the temperature at which this fluid is in- 
jected being varied according to the degree of fever. (Physiological 
salt solution consists of chloride of sodium 9 parts, sterilised water 
1,000 parts.) 

Prophylaxis. Should a case of septic metritis occur in a byre con- 
taining other cows about to calve the building should be disinfected. 



ACUTE METRITIS. 

The term " acute metritis " is used to indicate a variety of inflam- 
mation of the uterus of a sufficiently grave character, which, however, 
does not prove fatal in twenty-four or forty-eight hours. 

Causation. In domestic animals acute metritis develops exclusively 
after difficult parturition and as a consequence of the tearing of tissues 
or accidental post-partum infection. 

At one time it was the rule to recognise a traumatic form consequent 



ACUTE METRITIS. 551 

on wounds by embryotomy hooks, crutches, cords, etc, etc. There is 
no reason for maintaimng this distinction, because the essential condi- 
tion for the development of metritis is the infection of the injuries. 

Acute metritis follows non-delivery, incomplete delivery, or acci- 
dental infection. 

Symptoms. The external signs are very few, and must be carefully 
studied, in order that wrong conclusons may be avoided. 

Certain of these external signs suggest general disturbance such as 
one finds in all acute visceral inflammations, viz., loss of appetite, pro- 
gressive wasting, irregular slight fever, diminution or cessation of the 
secretion of milk, dulness, etc. 

The others are purely local. The discharge from the vagina is 
mucoid, muco-puralent, sanguinolent or foetid, according to circum- 
stances. It is small in quantity, and occurs only when the animal 
lies down or makes expulsive efforts. Examination with the specu- 
lum reveals the existence of slight secondary vaginitis and more 
intense inflammation of the neck of the uterus, which remains half 
open. Rectal examination shows that the uterus is abnormally large 
and more difficult than usual to displace. If acute metritis has 
existed for some weeks, the uterus is painful to the touch, and some- 
times fixed in position in consequence of the development of para- 
metritis and of slight pelvi-peritonitis, the occurrence of which is 
always indicated by temporary tympanites. 

Cases of acute metritis may recover spontaneously, but they rarely do 
so. The condition usually tends to become chronic or to be complicated 
with peri-uterine diseases which may prove fatal. 

Diagnosis. The diagnosis can be established without difficulty by 
rectal examination and direct examination with a speculum. 

Prognosis. The prognosis is grave, because the patients are tem- 
porarily or permanently incapable of becoming pregnant, and because 
acute metritis may be complicated with pelvi-peritonitis, phlebitis of 
the intra-pelvic veins, etc. 

Treatment. The uterus, and particularly the uterine mucous mem- 
brane, being affected, all our efforts should be concentrated on that organ. 
A careful study of the lesions shows that the glandular follicles are 
infected, and with them the entire thickness of the mucous membrane. 
The object to be attained, therefore, is the perfect disinfection of this 
tissue. The parts should repeatedly be washed out with warm water at 
blood-heat, followed by antiseptic injections containing 4 drachms of 
chloral per pint ; a 1 in 2,000 iodine solution or 20 per cent, to 25 per 
cent, hydroxyl solution, etc. Despite such injections, the inflamma- 
tion disappears slowly and with difficulty, and when the neck is suffi- 
ciently open it might perhaps be possible, as in human medicine. 



552 GENITAL APPARATUS. 

slightly to curette the mucous membrane of the uterus and plug the 
cavity with iodoform gauze. 

Where, however, the neck of the uterus is so far contracted as no 
longer to admit a sound or canula for irrigation, the difficulties are very 
great. Nothing effectual can be done until the neck of the uterus is 
dilated, an exceedingly troublesome operation. 

In the forms termed " post-partum traumatic metritis " antiseptic 
injections must not be made with any considerable pressure, because 
of the danger of rupture ; plugging the cavity with antiseptic gauze is 
preferable. 

CHRONIC METRITIS. 

Chronic metritis is often the termination of acute metritis, though in- 
flammation of the uterine mucous membrane may assume the chronic 
form from the first. All post-partum infections with pathogenic microbes 
may give rise to chronic metritis, as may the various forms of cystitis, 
vaginitis, rupture of the vulva, etc. Tuberculosis also leads to chronic 
metritis, which is easily diagnosed by a simple bacteriogical examination 
of the discharge. 

Symptoms. Chronic metritis is accomp)anied by bad general health 
and persistent local disturbance. The animals show a permanent muco- 
purulent discharge varying in amount, or simply an intermittent dis- 
charge, which is then more abundant and only lasts some hours or 
some days, but reappears after irregular intervals. On examination the 
neck of the uterus is found to be half open, slightly hypertrophied, 
sometimes sensitive, and covered with vegetations. 

Examination through the rectum may show the organ to be con- 
siderably hypertrophied, sensitive, and comparatively immobile. Cases 
are numerous, however, in which the examination reveals nothing 
very striking. 

In other cases, vaginal examination by means of the speculum reveals 
nothing, except that the neck of the uterus is completely closed, and yet 
on rectal examination the uterus is found to be of large size, tense, uni- 
formly fluctuating, and in exactly the position to be expected were the 
animal pregnant. This clinical form was formerly termed '' hydro- 
metritis," but it would be better named " pyo-metritis," inasmuch as it 
depends on chronic metritis. The neck of the uterus remains con- 
tracted, and the morbid products accumulate in the body and uterine 
horns, which are gradually dilated. Then suddenly the uterus is 
seized with reflex contractions overcoming the resistance of the neck 
and expelling the contents in one jet. The discharge may continue 
for some days, after which the neck again closes and the disease 
enters on a new phase. 

Lesions. The lesions affect the mucous membrane, more particularly 



EPIZOOTIC ABORTION IN COWS. 553 

the glandular tissue and the interstitial tissue. From the anatomical 
and pathological point of view different forms are recognised, some with 
glandular and mucous atrophy, others with marked hypertrophy, the 
mucous membrane being covered in some cases with vegetations and 
fungus-like growths. 

Diagnosis. From a clinical standpoint, it is only necessary to dis- 
tinguish the ordinary forms from tuberculous metritis, which latter is 
of no clinical importance on account of the impossibility of treatment. 

Prognosis. The prognosis is grave, as in all chronic diseases. 
Furthermore the animals are, for the time being, sterile and diffi- 
cult to fatten. 

Treatment. One of the fundamental conditions of treatment is to 
attack the disease locally, and it is necessary, therefore, that the 
uterine neck should be dilated. 

If the neck of the uterus is pervious, the parts must be washed 
out daily with antiseptic solutions, after having lightly curetted the 
mucous membrane with a blunt curette. Boiled water is first used, 
and is followed by solutions of chloral, iodine, hydroxyl, or per- 
manganate of potash. 

When the neck of the uterus is contracted, it must first of all be 
dilated. In practice such treatment is sometimes considered too costly, 
so that the animals are slaughtered or recovery is left to chance. 

Moussu has seen several animals suffering from metritis, and even 
from salpingitis, recover sjDontaneously after six to eight months at grass. 

EPIZOOTIC ABORTION IN COWS. 

This disease, which was carefully investigated, first by Professor 
Nocard of Alfort, and afterwards by Professor Bang of Copenhagen, may 
be regarded as a specific uterine catarrh, determined by a definite 
species of bacterium. 

It often affects large numbers of animals in one district or on 
one farm, and causes very serious loss. It is conveyed from cow to 
cow either by the bull or by litter or utensils used in the byre which 
have been soiled by the uterine discharges of an infected cow. As 
in many other infectious disorders, one attack of the disease seems 
to confer a certain immunity, and although some cows become sterile 
after an attack and others continue to abort, a certain proportion 
after aborting two or three times acquire relative immunity, so that 
they conceive and carry their calves the full time. This is probably 
why epizootic abortion usually ceases after some years in herds which 
are kept isolated and do not receive fresh recruits. 

The microbe of epizootic abortion is a very small bacterium which 
stains w^U with LofBer's methylene blue. When massed together 



554 GENITAL APPARATUS, 

these bacteria resemble cocci, but isolated specimens are seen to be 
true bacteria containing one, two, or occasionally three roundish, 
elongated deeply-stained granules. They do not stain with Gram, 
and are non-motile. 

These bacteria exhibit remarkable vitality. Bang relates cases 
which seem to prove that they may exist within the uterus for at 
least fourteen months, and in the uterine exudate outside the body 
for at least seven months, even at comparatively low temperatures. 

On post-mortem examination one finds between the mucous mem- 
brane of the uterus and the foetal envelopes an abundant odourless 
exudate, dirty-yellow in colour, somewhat thin, pultaceous, slimy, or 
lumpy in character. Under the chorion is found a thin, clear, gela- 
tinous substance contained within the fine connective tissue lying 
between the chorion and allantois. The umbilical cord is often oede- 
matous. All these exudates contain the specific minute bacterium. 

The above exudate forms the peculiar dirty, reddish-yellow, slimy, 
flocculent, pus-like odourless fluid which escapes from the vagina 
during or immediately after the act of abortion. 

The results of infection of the uterus with Bang's bacterium 
may be delayed for a considerable time. In two cases where he 
injected pure cultures into the vaginae of pregnant cows no apparent 
local results had been produced at the end of thirty-three and thirty- 
five days respectively when the cows were slaughtered ; but in the 
case of two other pregnant cows, inoculated three months after con- 
ception, signs of abortion became a23parent, and one cow in fact 
aborted in about ten weeks ; post-mortem examination revealed the 
characteristic local changes, and microscopical and cultural prepara- 
tions clearly established the presence of the specific organism. 

Although the sexual organs form the usual channel of infection, 
it seems possible that the organism may in some cases enter the 
body through the respiratory or digestive tract. 

The treatment in this condition is chiefly of a prophylactic 
character. Bulls which have served cows belonging to herds known 
to be infected should not be allowed to cover healthy cows. They 
should undergo careful local disinfection, and for a time be with- 
drawn from the stud. 

Cows which show signs of impending abortion should at once be 
removed to a separate shed. The foetus and its envelo|)es should 
be buried or burnt, and the person who attends the diseased cow 
should be prohibited from entering the common cow- shed. 

Where space does not admit of this the affected cows should be 
removed as far as possible from those still healthy and placed in a 
separate row. When they abort the after-birth should b^ removed 



SALPINGITIS — SALPINGO-OVARITIS. 555 

by hand, and the uterus daily washed out with some non-m-itant 
but effectual dismfectant. Even after apparent recovery a period of 
probation should elapse before the cow is again put to the bull. 

The genital organs and vaginae of the still healthy animals may 
also be irrigated with a disinfectant solution, in order, if possible, to 
ward off infection. For disinfecting the channels and floor of the 
stable quick-lime will be found clean, non-odorous, cheap and effective. 

In dealing with this disease one must always bear in mind the 
great vitality of the bacterium, the relatively long time it may per- 
sist either in the animal's body or in the infected sheds, and the 
considerable period which may elapse before its effects become evident. 

The same or a similar organism seems capable of producing 
abortion in sheep and mares. 

SALPINGITIS- SALPINGO-OVARITIS. 

This section will be brief, because the condition is very far from 
having been thoroughly elucidated. Moussu himself has only studied 
a single case of simple suppurative salpingo-ovaritis. 

Salpingitis and salpingo-ovaritis, i.e., inflammation of the Fallo- 
pian tubes and of the ovaries, can only develop as a consequence of 
ascending infection, as a complication of acute or chronic metritis, 
by auto-infection during the course of tuberculosis, or as an accident 
during what is known as tubal gestation. 

Tuberculous salpingitis is frequent, and exists in a very large 
majority of cases of genital tuberculosis. Accidental salpingitis as a 
consequence of tubal gestation is extremely rare, and is usually over- 
looked or mistaken for some other condition. 

From the clinical standpoint, therefore, we recognise two varieties 
of salpingitis — the one suppurative, the other tuberculous. 

Symptoms. The external symptoms are similar to those of 
metritis, because salpingitis develops as a complication of metritis 
after parturition, abortion, or retention of the after-birth. The only 
external symptom is a discharge of varying quantity from the vulva. 
This may be intermittent or permanent, and it is accompanied by 
frequent expulsive efforts in no respect characteristic. 

The nature of the lesions is ascertained by rectal examination, and 
as lesions of the uterus, of the Fallopian tube, and sometimes of 
the ovary often co-exist, the examination must be carried out me- 
thodically and gently in order to distinguish between the parts 
touched. The normal relationships may be modified by uterine 
lesions, inflammatory adhesions, local peritonitis, etc. 

Diagnosis. The diagnosis requires care. 



556 GENITAL APPARATUS. 

Prognosis. The prognosis is grave. The lesions are too deep- 
seated to be directly attacked, and, moreover, salpingitis may termi- 
nate in pyo-salpynx, i.e., in encysted abscess of the Fallopian tube. 

Treatment. The treatment is similar to" that of metritis. The 
natm'al opening of the Fallopian tube into the uterus allows pus 
and morbid products to escape, and when the metritis disappears 
the salpingitis may diminish and recovery may take place. 

Treatment therefore is quite indirect, for in veterinary surgery it 
is useless to attempt to repeat on large domestic animals the brilliant 
operations of human surgery. The relations between uterine diseases 
and those of the Fallopian tubes are so close that this method of 
treatment gives excellent results. Moussu has seen a case of chronic 
metritis complicated with salpingitis recover after simple uterine treat- 
ment. 

TORSION OF THE UTERUS, 

Although torsion of the uterus is a condition more particularly 
pertaining to the domain of obstetrics, a few ^remarks on the subject 
may not be altogether out of place at this point. 

The accident is commonest in the cow, but it has also been described 
in the mare, ewe, bitch and cat, and it probably occurs, though less 
frequently, in the other domestic animals. In the cow it is com- 
monest during the last month of pregnancy. 

Very little is known as to its cause, though the consensus of opinion 
' — if any consensus can be said to exist in face of the existing diver- 
gent views — appears rather to indicate that it follows falls in awkward 
positions, sudden efforts, severe prolonged exertion, or tympanites. 

In pregnant cows the uterus assumes the appearance of a pen- 
dulous organ the body and horns of which constitute the bob of the 
pendulum, whilst the ligaments represent the cords by which it is 
suspended. The fixed points are formed by the insertions of the two 
ligaments in the neighbourhood of the two external iliac angles. 

The uterus, however, is also steadied in position by the vagina 
and by the cellular tissue surrounding it ; in fact, in non-pregnant 
animals it can scarcely be regarded as pendulous, but rather as freely 
floating and readily yielding to the movements of the surrounding 
organs. 

As soon as the uterus is occupied by a foetus, however, the con- 
ditions become changed. In consequence of the increased weight of 
its contents the uterus exerts a pull on the broad ligaments and 
sinks lower in the abdominal cavity. The vagina and the surround- 
ing connective tissue are rendered tense to a degree depending on the 
increasing weight of the calf. The uterus then more closely resembles 



TORSION OF THE UTERUS. 557 

a 23endnlum, the bob being represented by the foetus and its envelopes. 
The suspensory apparatus can be divided into three parts, viz., the 
two broad ligaments and the tissue connecting the uterus to the 
vagina. 

The pull on the vagina increases greatly as soon as the gravid 
uterus is twisted either to the right or left, for, torsion being attended 
with more or less extensive displacement towards the lower abdominal 
wall, the tension on the vagina must become more marked. 

Considering now how the spiral folds and the constrictions which 
are of such importance in diagnosis are formed, w^e find that both 
structures, viz., the wall of the uterus and the ligaments, are impli- 
cated, though to different degrees. Whilst the spiral folds are more 
particularly formed by the wall of the uterus, the broad ligaments are 
chiefly responsible for the constrictions, though to some extent the 
spiral folds also contribute to their production. The spiral folds of 
the body of the uterus are formed solely by twisting of its own w^alls. 
This can easily be shown by taking any tubular organ whose walls 
are not too rigid, and twisting it round its horizontal axis. 

The broad ligaments contribute less to the formation of the spiral 
folds, though they play a more important part in producing con- 
strictions and thus in compressing the wall of the uterus. 

The symptoms are ill-defined. Sometimes there is difficulty in 
micturition, but as a rule little evidence exists of any abnormal con- 
dition until the advent of labour pains. The first pains, which are 
usually feeble and separated by rather long intervals, are succeeded 
by colic. The succeeding efforts steadily become more violent and 
frequent, but the "water-bag" fails to appear, and in a period^ varying 
between twelve and forty-eight hours the pains subside. Eumination 
is at first suspended, the pulse and respiration are accelerated, and 
the surface temperature is irregular. 

If treatment is not undertaken simila^r symptoms, but of exaggerated 
intensity, may again appear in from one to six days. Failing relief 
death always follows after a varying interval. 

The diagnosis is not difficult, provided the maternal passages be 
examined. On passing a carefully lubricated hand into the vagina the 
operator discovers, at a varying distance from the os uteri, signs of 
collapse and twdsting of the canal. In cases of quarter twist it is 
often possible, by rotating the hand so as to follow the spiral folding 
of the vagina, to introduce the fingers as far as the os uteri ; but in 
half or complete rotation only one or two fingers can be passed so 
far, or it may be altogether impossible to reach the os. 

In the Berliner Archiv for 1902 Lempen gave a summary of the 
extensive literature dealing with this disease and of the varying views 



558 GENITAL APPARATUS. 

held regarding its origin and treatment, particularly as to the direction 
in which the animal should be rolled in order to reduce the torsion. 

In common with the majority of authors, Lempen rightly con- 
cluded that the rolling should be in the same direction as the torsion. 
He also proposed to describe the torsion as being to right or left, 
according to the direction of the spiral folds to be found on the upper 
wall of the dilated cervix uteri when the examiner stands behind the 
animal. This mode of describing the changes seems least likely to 
cause misunderstanding. 

In describing the degree of torsion Haase takes as his index the upper 
wall of the uterus. Where this has moved through an angle of 90 degrees 
he speaks of quarter torsion ; when through an angle of 180 degrees (in 
which case the upper wall will have become the lower) of half or semi-com- 
plete torsion ; when through an angle of 270 degrees as three-quarter, 
and when through 360 degrees (the upper wall having then described 
an entire circle and returned to its former position) as complete torsion. 

In forming a diagnosis, the extent to which the maternal passages 
seem fixed in position, the amount of resistance they offer to the hand, 
and the degree of tension in the spiral folds to some extent indicate 
how far torsion has proceeded. Where the spiral folds are very tense 
and the passages completely immovable, so that the operator cannot 
reach the foetus, torsion is usually complete ; in cases of less complete 
torsion (one-quarter to three-quarters) the cervix uteri is closed and 
displaced to a proportionate extent, and the resistance to the passage 
of the hand is in keeping. 

The prognosis is very grave. 

Treatment is difficult, and of the numerous methods suggested 
(laparotomy and direct abdominal taxis, vaginal hysterotomy followed 
by abdominal taxis, vaginal taxis, etc.) most have fallen into desue- 
tude or are looked on as of so desj)erate a character as only to be 
justified in extreme cases. That which most merits attention and 
has been attended by most uniformly favourable results consists in 
the rotation of the animal's whole body. The best results are said to 
be obtained by casting the animal, or causing it to lie down, on a 
sloping surface with the hind quarters higher than the fore and then 
to roll it down hill, in the same direction as the spiral twists discovered 
in the vagina. It is possible to follow the course of the manipulation 
by retaining the hand in the vagina, but failing this the vagina should 
be examined after each attempt. Even though the first attempts fail 
hope should not be abandoned, for Haase has succeeded in effecting 
delivery after rolling the animal twenty times. The operation should 
be performed smartly and the animal's body be rolled as a whole, 
the fore limbs turning along with the hind. 



TUMOURS OF THE OVARY. 559 



TUMOURS OF THE UTERUS. 



The study of tumours of the uterus is still so incomplete that it 
would be impossible to give a precise description of them. This is 
to a great extent due to the fact that as treatment is difficult the 
animals are usually slaughtered as soon as an assured diagnosis can 
be given. 

The general symptoms of tumours of the neck, body, or horns of 
the uterus resemble those of chronic metritis, viz., permanent or inter- 
mittent discharge from the vulva, wasting, expulsive efforts, dysuria 
and sterility. The position of the tumour, its form, point of insertion, 
size, consistency, mode of attachment, etc., can be detected by vaginal 
or rectal examination. 

The diagnosis having been made, the only question is as to treat- 
ment. Should the tumour prove mobile, clearly delimited, and with 
a well-marked pedicle, it can be removed either by tearing aw^ay or 
by breaking into fragments, or again simply by dividing the pedicle 
and applying antiseptic pads to check bleeding. But if the tumour 
proves largely sessile and ill-defined and it extends into neighbouring 
tissues the animal should be slaughtered, as such patients can neither 
be fattened nor used for reproductive purposes. 

TUMOURS OF THE OVARY. 

We might repeat in regard to tumours of the ovary what has 
just been said as regards those of the uterus, though the former 
are much commoner than the latter. 

Clinically, ovarian tumours may be grouped under two heads, solid 
tumours and cystic tumours — the first represented by the fibromata, 
fibro-sarcomata and epitheliomata, the second by uni- or multi- locular 
cysts. 

All these tumours are dangerous ; they may develop rapidly, and 
they rarely fail to produce disturbance, the animals presenting various 
genital troubles, among which may be mentioned sterility and nympho- 
mania. 

The cystic tumours, which develop at the expense of epithelial 
invaginations of the peritoneal covering or at the expense of Pfliiger's 
tubes, and not, as was formerly believed, by the morbid development 
of the Graafian vesicles, constitute dangerous growths, true cysto- 
epitheliomata or cystic epitheliomata, capable of producing fatal 
complications (vascular disturbance, local or general peritonitis, com- 
pression of the ureters, etc.). 

The diagnosis must be arrived at by vaginal and rectal examination. 



560 GENITAL APPAHATtrS. 

It is usually possible to distinguish the condition from disease of the 
kidney, bladder, or pelvic lymphatic glands. 

Treatment. The only possible treatment is removal of the dis- 
eased ovary and of the ovarian tumour, but much depends on circum- 
stances. If a large tumour has formed extensive adhesions, ablation 
may be impracticable or so dangerous that under the circumstances 
in which veterinary practitioners are forced to operate it cannot be 
undertaken. If, on the contrary, the ovarian growth is free and 
pedunculated, even though of large size, extirpation is possible. 

The method is exactly similar to that of castration of the cow, 
and follows the same rules, but the vaginal incision has to be much 
longer, so as to allow the entire hand to be passed as far as the 
tumour. The pedicle is divided by means of the ecraseur, which 
should be worked very slowly. In removing very large tumours, 
however, it is possible to operate from the flank. 

GENITAL MALFORMATIONS, 

IMPERFORATE VAGINA. 

Many forms of genital malformation occur, but only those which 
produce sterility are pathologically important. 

One alone causes very marked disturbance, viz., imperforate vagina. 
This condition may be accidental or acquired, and may follow either 
difficult parturition, Avith circular lesions of the vagina, or burns or 
cauterisation of the vagina, followed by adhesion of its walls. 

It is generally of congenital origin, and the obstruction as a 
rule is in the region of the hymen, as a consequence of some 
anomaly in development, and not of abnormal development of the 
hymen itself. 

■ This imperforate condition of the vagina is not attended by grave 
consequences during early life ; but later, when the generative func- 
tions become active, all the products of secretion of the uterine and 
vaginal mucous membranes accumulate in the closed cavity, giving 
rise first to muco-metritis, then to muco-kolpitis, similar in its develop- 
ment to the haemato-kolpitis of young girls. The uterus gradually 
becomes distended with liquid, the neck is dilated, and a portion of 
the vagina may attain enormous dimensions, so much so as to suggest 
pregnancy. 

Symptoms. The symptoms become appreciable only after a time 
— about one year or fifteen months in heifers — and they seem to be asso- 
ciated with the appearance of oestrum. The animals make continued 
expulsive efforts, which when the genital canal is much distended may 
become extremely violent. There is also dysuria as a consequence of 



IMPEKFORA.TE VAGINA. 



561 



compression, together with uterine and vesical colic, loss of appetite 
and wasting. 

Diagnosis. The diagnosis requires care, and can only be arrived 
at after examination of the vagina and examination per rectum. In 
young females this examination is extremely difficult, because of the 
narrowness of the genital tract and of the rectum. For vaginal exami- 
nation we j)refer to use a small speculum, which exposes the depths of 
the vagina or the transverse septum without necessitating other 
manipulation. On rectal examination the uterus and vagina are 







^ 

::^i 



Fig. 235. — Imperforate vagina : position and appearance of tlie genital organs. Cu 
Distended uterine horns (muco -metritis) ; Ya, dilated extremity of the vagina ; 
Ye, bladder, distended with mdne, owing to compression of the urethra. The hymen 
was situated about 1| to 1-g- inches in front of the meatus urinarius. 



sometimes found to be enormously enlarged, and to contain a quantity 
of fluid, but no foetus. 

Prognosis. The prognosis is grave. Unless treatment is under- 
taken the animals die in consequence of exhaustion or secondary 
peritonitis. 

The treatment is simple, and consists in aseptic puncture of the 
septum and evacuation of the contents. The operation is carried out 
with a long, large- sized trocar, which is passed through the centre of 
the most prominent portion of the transverse septum where it projects 
towards the vulva. Five, ten, or fifteen quarts of mucous fluid escape, 
and the constitutional disturbance disappears almost instantly. 



D.C 



o o 



562 GENITAL APPARATUS. 

Antiseptic precautions are necessary in order to avoid the develop- 
ment of secondary pyo-metritis. The artificial orifice can afterwards be 
gradually dilated to allow free exit to the discharges, but in practice, as 
the animals cannot be used for breeding purposes, they are usually 
fattened for slaughter. 

NYMPHO'MANIA. 

The term ''nympho-mania" is employed to describe a special con- 
dition in female animals which is manifested by continual sexual 
excitement. The animals are almost always sterile. The disease is 
most frequent in cows. 

Causation. This general condition may depend on one of many 
causes, but is rarely due to a true neurosis, as was once believed. 
Some morbid influence of genital origin. is always responsible for the 
appearance of the symptoms. 

Nympho-mania, therefore, often co-exists with lesions of the ovaries 
(simple ovaritis, cystic ovaritis, tumours of the ovary), with lesions of 
the Fallopian tubes and of the uterus (salpingitis, chronic metritis 
and tumours of the uterus), with chronic vaginitis and lesions of the 
clitoris (hypertrophy and tumour formation), and even with peri- 
vaginal or peri-uterine lesions (cysts or tumours). 

In exceptional cases it may be found occurring as a simple nervous 
disturbance without genital lesion, and it would then appear to be due 
to some temporary genital affection having produced nervous irritation. 

In short, nympho-mania may be considered as almost iiTvariably the 
result of a genital lesion. 

Symptoms. The symptoms are very clearly marked. They consist 
in persistence of the sexual appetite, which is quite abnormal in female 
domestic animals. The patients lose flesh, feed badly and irregu- 
larly, annoy their fellows, cause accidents, and sometimes become 
dangerous. 

Diagnosis. The diagnosis of nympho-mania is so simple that the 
condition is generally recognised by the owners or cow-herds. The 
only difficult point lies in discovering the exact cause. Complete 
examination of the genital organs per rectum and per vaginam is 
absolutely necessary to settle this question. 

Prognosis. From an economic standpoint the prognosis is gene- 
rally grave. 

Treatment. The treatment varies considerably, according to the 
nature of the lesion. 

In mild cases where nympho-mania is due to some lesion of the 
clitoris (balanitis, hypertrophy, or tumour formation), the radical 
treatment consists in clitoridectomy. The operation is comparatively 



NYMPHO-MANIA. 



563 



slight, the organ being removed with forceps and scissors, or with a 
bistoury after the animal has been hobbled or placed in a trevis. 
The hgemorrhage which follows removal of the clitoris is of little im- 
portance, and after-treatment simply consists in keeping the parts 
clean. 

Animals so treated can sometimes be preserved for breeding. 

When nymph 0- 
mania co-exists 
with, and is a de- 
layed consequence 
of, either chronic 
vaginitis or metri- 
tis localised in the 
neck of the uterus, 
or, again, chronic 
metritis of the 
cavity of the uterus, 
etc., the treatment 
must be directed 
against these 
diseases, and the 
nervous condition 
may be sufficiently 
modified to render 
the animals useful 
for breeding, or at 
least for slaughter, 
while fattening is 
easy. 

Similarly, when 
the nervous condi- 
tion results from a 
lesion of the ovary, 
improvement will 
only follow re- 
moval of the 
diseased part. The 

operation is similar to that of castration of the female. It presents, 
however, certain added difficulties, in consequence of the size of the 
organs and of the abnormal adhesions which often occur. Neverthe- 
less, these difficulties are seldom insurmountable. 

In the case of peri-uterine disease operation is difficult, and it is 
better to slaughter the animal. 

o o 2 




Fig. 236. — Specimen of lesions found in nympho-mania. 
V, Vagina laid open ; Cu, neck of the uterus ; 0,0, 
ovaries ; Cd, right horn of the uterus ; Cg, left horn of 
the uterus ; K,K,K, peri-uterine cysts. 



564 GENITAL APPARATUS. 

Finally, as ma}- occasionally happen, should there be no congenital 
lesion capable of explaining the appearance of nympho-mania, the 
disease may be regarded as a neurosis, and may then be treated by 
such sedatives as the bromides of potassium, sodium and strontium, 
in doses of 2 to 3 drachms per day, divided into two or three 
portions. Bromide of camphor also gives excellent results by acting 
simultaneously on the nervous system and calming excessive genital 
irritation. 

The above method of treatment is much preferable to performing 
clitoridectomy, or ovariotomy as a kind of panacea, although certain 
writers have suggested these operations without taking into account 
the special local conditions. 



CHAPTER V. 
DISEASES OF THE MAMMARY GLANDS* 

In animals used for the purpose of providing milk, viz., cows, 
goats, and milch ewes, diseases of the mammary glands are of daily 
occurrence, but are rare in those in which the mammary function is 
limited to the nourishment of the young, such as the mare, female ass, 
sow, etc. 

In order clearly to understand the development of these diseases, 
it is necessary to bear in mind the anatomical construction of the 
organs, for which purpose we may take as a type the mammary gland of 
the cow, which is the most complicated. 

The udder of the cow is of hemispherical shape. It is situated in 
the inguinal region, and is composed of two parts, the right and left, 
which are absolutely independent and can easily be isolated from each 
other along the median plane throughout their extent. The mass of 
parenchyma is enveloped in a fibrous envelope, which is covered with a 
very loose layer of subcutaneous connective tissue. Each half is sub- 
divided into two quarters, an anterior and a posterior quarter. Each 
quarter again represents a distinct gland, although anatomical separa- 
tion between the anterior and the corresponding posterior quarter would 
be almost impossible, the separating fibro-connective partition being 
common to both glands. 

In very good milkers it sometimes happens that two small supple- 
mentary glands may be found bebind the posterior quarters, bringing 
up the total number to six. 

Parenchyma. — Each of these glands is provided with a teat contain- 
ing a large sinus. Anatomically the mamma consists of glandular tissue 
arranged like a bunch of grapes, in which the active tissues of the acini 
deliver their secretion into little excretory canals, which unite, forming a 
large collecting plexus. The collecting canals, or galactophorous canals, 
open into the galactophorous sinus, which occupies the entire depth of 
the teat and communicates with the exterior by a small pore provided 
with a sphincter. The interacinous connective tissue of the udder and 
the subcutaneous tissue of the teat, which envelops the galactophorous 



566 



DISEASES OF THE MAMMARY GLANDS. 



sinus, is extremely rich in elastic fibres, enabling the organ to undergo 
great changes in volume without injury. 

Vessels. — The mammae are supplied by two great arteries, the 
mammary arteries, which are given off from the prepubic arteries, pass 
into the inguinal canal, and penetrate the gland by its upper, deep face. 
Each principal lateral artery divides into two trunks, one for the 
anterior, the other for the posterior quarter. 

The veins which collect the blood from the mammae form two 
systems, the first accompanying the mammary arteries, the second, 

more superficial, 

VM. — Urn LE '^ ' 

VlCa, . AM. 




G-.HM. 



givmg rise to the 
anterior sub- 
abdominal mam- 
mary veins. The 
arter io-venous 
plexus of the 
udder, which re- 
presents the vas- 
cular pedicle of the 
organ, penetrates 
the gland, near a 
line dividing the 
posterior and 
middle thirds of 
the upper surface, 
an inch or so in 
front of the mam- 
mary lymphatic 
gland. 

Lymphatics.— 

On either side of 

the middle line lies 

an extremely rich lymphatic plexus, the origin of which is to be foun<i 

near the ends of the teats and in the peri-acinous spaces. 

The superficial collecting vessels are dispersed under the skin, 
perforate the fibrous sheath towards the base of the teat, and anastomose 
with one another on the surface of the gland, the anastomosis being 
most intimate between those of the same quarter, finally emptying 
separately by two large trunks into the retro-mammary lymphatic gland 
of the same side. 

The vessels of the anterior quarter enter the lymphatic gland at 
its most anterior point ; those of the posterior quarter join it a little 
below. 



Fig. 237. — Schema showing the structure and organisation of 
the udder. Antero-posterior section showing the arrange- 
ment of the anterior and posterior quarters and the teats, 
skin, transverse partition, etc. GEM, Eetro -mammary 
lymph gland ; L^j, lymphatics of the posterior quarter ; 
L<z, lymphatics of the anterior quarter ; LE, efferent lym- 
phatics ; AM, mammary artery ; VM, mammary vein ; 
VM«, anterior mammary vein (subcutaneous abdominal 
vein) ; C, transverse inter-mammary septum. 



PHYSIOLOGICAL ANOMALIES. 567 

The retro-mammary lymphatic glands are t^YO in number, and are 
situated very high and towards the back, above the posterior quarters 
and close to the perineum, outside the fibrous envelope of the gland. 
They are sheltered in a recess excavated within the depths of the gland 
itself. The main collecting lymphatics from the anterior and posterior 
quarters enter it separately. 

The lateral efferent vessels are divided into two groups, one 
of which ascends vertically in the perineal region, towards the 
lymphatic glands round the anus ; the other passes through the in- 
guinal canal towards the sub-lumbar region, together with the blood- 
vessels. 

The mammary nerves are two in number. The anterior has a 
downward course outside the fibrous envelope and supplies the teat ; 
the posterior nerve is similarly distributed. In other domestic female 
animals which have only two mammae the general arrangement is 
precisely the same. 

PHYSIOLOGICAL ANOMALIES* 

Imperforate condition of the Teat.— It sometimes happens that 
although the udder is otherwise well formed, the teats, or more 
frequently a single teat, proves to be imperforate* Between the galac- 
tophorous sinus and the exterior, opposite the sphincter, a little 
membrane may be found which closes the teat and entirely prevents 
the contents of the udder from escaping. Its existence is only dis- 
covered when the -animal first calves and lactation commences. Not a 
drop of milk can be withdrawn, although the udder is sw^ollen. Local 
examination readily reveals the defect. 

Treatment is very simple and effective, the membrane being per- 
forated with the end of a milk catheter. 

Contraction of the Sphincter (Atresia of the Extremity of the Teat), 
—Under other circumstances the teat may present a distinct per- 
foration, and yet milking may be impossible, or at all events may be 
extremely difficult. This is sometimes due to contraction of the sphincter, 
or possibly to atresia of the orifice. 

The diagnosis of this condition is easy, but the outlook is not 
promising. 

Treatment is rather difficult. Some operators recommend dividing 
the terminal sphincter with a small, specially-formed bistouri cache^ 
provided with two cutting points. The operation has very satisfactory 
immediate results, but after the little w^ounds so produced have healed^ 
cicatricial contraction takes place around the orifice. 

Forcible dilatation is far preferable* It is carried out in the same 
way as in human medicine, where the sphincter ani or the orifice of 



568 DISEASES OF THE MAMMARY GLANDS. 

the uterus has to be dilated. No superficial lesion and no incision is 
produced; the result is therefore more permanent (see "Operative 
Technique"). 

WOUNDS OR TRAUMATIC LESIONS, 

CHAPS AND CRACKS. 

These injuries consist in little transverse or oblique wounds of the teat. 

Causation. In free milkers the udder appears completely relaxed 
after milking. In the intervals between the different milkings, however, 
the quarters become swollen, and are sometimes so distended as to over- 
come the resistance of the sphincter at the base of the teat. The teats 
are then greatly elongated, and, despite the richness of the tissues in 
elastic fibres, this distension leads to little superficial epidermic fissures. 

These small lesions are unimportant, but if they become infected 
by contact with the litter they granulate and suppurate, so that grave 
complications may eventually follow. 

The wounds caused by the calves' teeth when sucking, or simjoly by 
the rough way in which the little animal seizes the teat, may produce 
similar accidents. 

Symptoms. The teat shows one or more little transverse fissures, 
a few millimetres to a centimetre or more in length. The base of the 
fissure appears of a reddish or brownish-red colour, and has thickened, 
indurated, painful, discharging or suppurating margins. Local sensi- 
tiveness may be either slight or very pronounced. I-n the latter case, 
the patients resist being milked, and even refuse to let the calf suck. 

Diagnosis. The diagnosis is extremely simple. 

In a general sense the prognosis is favourable, but nevertheless the 
local infection may extend and become generalised, thus giving rise to 
interstitial mammitis, sometimes of a very grave character. On the 
other hand, the sensitiveness may of itself render milking difficult or 
impossible, and thus cause serious distension of the gland with milk. 

Treatment. As both sucking and milking aggravate the lesions, they 
should be prevented by the insertion of a milk catheter. 

The surface of the udder and the wounds should be cleansed with 
an antiseptic solution and be dressed with a 20 per cent, campho- 
rated vaseline or with carbolic or iodoform ointment, to favour healing. 
If the cracks produce excessive sensitiveness a small quantity of 
orthoform may be added to the camphor ointment. Before the milk 
catheter is inserted, the teat should be very carefully cleansed with 
boiled water and the catheter sterilised by boiling. Neglect of these 
precautions may result in infection of the galactophorous sinus and 
mammitis. 



MILK FISTULA. 



569 



MILK FISTULA. 

Causation. Any accidental injury to the udcler which establishes 
connection between the galactophorons canals or the galactophorous 
sinus and the exterior may give rise to milk fistula, if the injury 
occur during lactation. 

Apart from lactation these wounds may be grave, though if care- 
fully treated they heal without compHcation. During lactation, on 
the contrary, the milk escapes permanently from the injured spot, 
cicatrisation cannot occur, and a fistula forms. 

Symptoms. The principal symptom is the permanent discharge of 
milk. The fistula may be large or small, according to circumstances. 
In rare instances it is 
situated on the udder 
itself, but . it is com- 
monest on the teat. 
Milk may escape in 
mere drops or, on the 
other hand, in con- 
siderable quantities. 

Diagnosis. The 
diagnosis presents no 
difficulty. 

Prognosis. The 
prognosis is grave so 
far as the loss of milk 
is concerned, although 
the lesion has no 

effect on the general health. It is particularly serious, however, because 
it may cause the interior to become infected, and an acute parenchy- 
matous mammitis may thus be set up. It must also be borne in mind 
that old fistulffi are much more difficult to obliterate than recent ones. 

Treatment is much more troublesome than might at first be thought, 
the great obstacle to repair being the continual secretion and discharge 
of milk. 

At first, attempts should be made to re-establish and render permanent 
the natural method of discharge. This can be effected by inserting an 
aseptic milk catheter and fixing it in position with a little pitch bandage. 

The course of the fistula is then cleansed, curetted, and rendered 
aseptic in some way, as for example by washing with boiled salt solution 
and dilute hydroxyl. 

As there is little hope of obliterating the fistula by merely suturing 
the skin, its course should first be closed by passing one or two deep 





Fig. 238. — Milk fistulae. 1, Deep suture — schema show- 
ing the course of the suture ; FL, base of the fistula ; 
S, suture ; 2, superficial interrupted suture. 



570 DISEASES OF THE MAMMARY GLANDS. 

sutures without touching the external orifice and without passing over 
it (Fig. 238). The discharge of fluid being then entirely stopped, the 
external portion of the fistula is thoroughly cleansed, powdered with 
iodoform, and finally closed with external, closely-applied sutures. These 
sutures are protected with a little cotton-wool or collodion dressing, and 
healing then almost invariably occurs. 

The animal should be given a very clean bed, and closely watched 
to prevent it tearing out the milk catheter. On the fourth or fifth day 
the catheter is removed, and is afterwards only used at intervals. 

As all the sutures can be of aseptic catgut or silk, there is no 
necessity to trouble about their removal. The dressing can be left 
until it falls away of itself. 

INFLAMMATORY DISEASES. 

CONGESTION OF THE UDDER. 

Congestion — i.e., distension of the vascular plexus as a consequence of 
momentary stasis, vaso-motor disturbance, or paralysis of the little vessels 
in the udder — -can only be regarded as pathological in cases when it pre- 
cedes mammitis or when it results from prolonged neglect to milk the 
animal, external irritation, etc. It was studied long ago by H. d'Arboval, 
Gelle, Delafond, Trasbot, Lucet, etc. 

Tt also occurs, but in a form which might almost be termed physio- 
logical, after the first parturition in the large milch breeds, where the 
rush of blood which precedes secretion is very great. 

Symptoms. The udder is- swollen, tense, doughy, shining, and 
oedematous, not very painful on pressure, but sufficiently so to interfere 
with movement. The general condition is little altered, but the tem- 
perature of the udder is abnormally high. 

Manipulation reveals the existence of more or less oedema, the parts 
preserving the imprint of the finger. Sometimes this oedema extends 
along the abdominal wall in front of the udder. The milk may be 
grumous or even sanguinolent. The congestive state continues for 
some days, eight to ten at the most, and may gradually disappear by 
resolution. Not infrequently it terminates in acute mammitis after 
forty-eight hours. 

Lesions. In simple mammary congestion the lesions are confined 
to excessive dilatation of the peri-acinous capillary vessels, and extrava- 
sation into the connective tissue. On section the tissue has a dark-red 
appearance. 

Diagnosis. The diagnosis is simple. 

Prognosis. The prognosis is less alarming than might at first sight 
be supposed. 



MAMMITlS. 



571 



The treatment consists simply in hygienic precautions, frequent 
milking, emollient, sedative applications to the udder, and frequent 
washing. As far as possible the use of milk catheters should be avoided. 

Boric vaseline and belladonna ointment may be recommended. In 
very serious cases blood can be withdrawn from the jugular. This is 
better than bleeding from the mammary vein, which alw^ays entails the 
risk of thrombus formation. 



MAMMITlS, 

Under the heading " mammitis " are included different forms of in- 
flammation of the mammary tissue, whether such inflammation attack 
the parenchyma of the gland or the interstitial tissue. Generally 
the whole gland is invaded at the end of a few days, whatever 
the point of origin, and the inflammation is therefore of a mixed 
character. 

Mammitis has been recognised from very early times. In his 
researches on "contagious mammitis" Nocard in 1884 showed that 
infection was the principal factor in its evolution. 

Numerous classifications, based on the causes or on the pathological 
anatomy of the condition, have been suggested ; but most appear too 
rigid, and therefore, without discussing them, we confine ourselves to 
giving the following resume : — 



Eainard (1845) . . 

Lafosse (1856) . . 
Trasbot (1883) . . 

Saint Cyr (1874) 
Violet (1888) . , 



Lucet (1891) 



Lacteal engorgment. 
Cellulitis of the udder. 
Maininitis . . 

1 Mammitis . . 
) 

[ Mammitis . . 



Primary mammitis (pro- 
perly so-called) . . 



Symptomatic mammitis , 



Acute. 

Chronic. 
I Acute. 
I Chronic. 

(Catarrhal. 
Phlegmonous or interstitial. 
Parenchymatous. 

r Galactogenous. 
i Lymphogenous. 
( Galactogenous. 
i Lymphogenous. 
f Haematogenous. 
i Lj'mphogenous. 
( Haematogenous. 
i Lymphogenous. 



Acute 



Chronic , 



Acute 



Chronic 



All these classifications ' are justified by the guiding ideas of the 
writers, yet, as in every case of attempted systematisation, they have 
the disadvantage of not being in entire agreement with clinical 
experience. 

For instance, the differences betw^een catarrhal and parenchymatous 



572 t)IgEASES OF THE MAMMARY GLANDJ^. 

forms of mammitis are only of degree, and it is difficult, therefore, to 
see why they should be divided into two distinct varieties. The differ- 
ence is in regard to the prognosis. 

Similarly in practice it is difficult and sometimes impossible to dis- 
tinguish between an interstitial and a parenchymatous mammitis, 
because all the tissues of the gland may be involved at a given 
moment. The only factor which allows of differentiation is the dis- 
covery of the point from which infection took place. Finally, it is 
sometimes so difficult to distinguish between galactogenous and lym- 
phogenous mammitis that the attempt has had to be abandoned. In 
gangrenous mammitis of milch ewes, for example, the infective organism 
is found not only in the sinus and the galactophorous canals, but 
also in the serosity of the interstitial tissue and of the perimammary 
oedema. 

Without doubt the causative agent of mammitis may enter the 
gland by three principal channels — the galactophorous sinus, the lym- 
phatic plexus (after some injury), and the blood circulation. But from 
the clinical standpoint it is not at all necessary to identify all the causes 
in order to establish the classification. 

The symptoms allow of a division only into acute and chronic 
mammitis. Careful examination of the general condition of the patients 
will afterwards allow cases of primary mammitis to be distinguished 
from secondary or symptomatic mammitis sach as occurs in tuberculosis. 
Finally, consideration of the conditions under which a particular case 
of mammitis has appeared, and study of the symptoms in detail 
(peculiarities of the milk, local temperature, hardness of the tissues, 
cedematous infiltration, etc.) will in most cases indicate whether the 
mammitis be parenchymatous or interstitial. 

This system really differs little from that adopted by Lucet in his 
work on Mammitis. 

The classification adopted in the following pages is as follows :— 

j Parenchymatous or galactogenous. 
[ Pri^ia^y • • I Interstitial or lymphogenous, 
f cute . . . . -j ge(3on(jary or ( Hsematogenous. 

I symptomatic, i Galactogenous. 
Simple. 



Mammitis 



I Primary 



^Chronic 



Parenchymatous. 
Interstitial. 



K^ , ( Parenchymatous. 

Secondary ■ • i' .,. , 

V i Interstitial. 



We shall leave on one side everything concerning secondary symp- 
tomatic mammitis, the study of which merges into that of the general 
diseases from which it arises. 



ACUTE MAMMITIS. 573 



ACUTE MAMMITIS. 



Causation. The general cause of acute mammitis, like that of 
chronic mammitis, is infection by pathogenic organisms, whether such 
organisms enter by the usual natural path, viz., the galactophorous 
sinus and excretory apparatus, by the lymphatic path, owing to some 
accidental injury, or, again, by the blood circulation. 

Infection of the lymphatics undoubtedly plaj^s a part in superficial 
and interstitial inflammations, and it is proved that certain micro- 
organisms may pass into the milk, as it has been proved that they 
pass through the kidney. 

But if infection is the determining cause, certain secondary favour- 
ing influences must not be overlooked. 

Thus lactation is an almost indispensable condition. It is true 
that some cases of mammary inflammation apart from lactation have 
been described, but they have been the result of violence, accidental 
or mechanical. 

Accumulation of milk in the udder (overstocking) has unquestion- 
ably a certain influence in the large milk-yielding animals, not because 
it directly produces inflammation, but because milk then escapes spon- 
taneously ; and as the udder cannot be entirely evacuated without 
external assistance, the entrance is kept permanently open for the 
passage of germs, which are freely transferred to the teat from the 
litter and surrounding objects. 

Cold, or rather chills, also act in a complex manner, particularly 
by disturbing vaso-motor control. Different forms of mechanical 
violence, such as blows, crushing strains, wounds, etc., may immediately 
and directly set up local or general inflammation. 

Bacteriological investigation has proved that numerous and varied 
micro-organisms can be found in the milk or interstitial exudates in 
cases of mammitis, but only a few special forms have been proved to 
be specific : streptococcus of contagious mammitis of milch cows, and 
micrococcus of contagious gangrenous mammitis of ewes (Nocard). 

Pathology. The pathogenic results produced by infective organisms 
depend on their number and power of reproduction, and on the activity 
of their life products. 

The most immediate and regular result of acute mammary infec- 
tion is coagulation of the milk within the udder by decomposition of 
the lactose, and the formation of lactic or even of butyric acid. The 
acini and excretory canals are dilated by coagula, and can no longer 
expel their products of secretion, so that the colonies of micro-organisms 
develop there in full security. The active epithelial cells undergo 
granular degeneration and disappear, whilst the walls of the glands 



574 DISEASES OF THE MAMMARY GLANDS. 

become infiltrated and large numbers of leucocytes are poured forth 
around the glandular culs-de-sac. 

The tissues being thus affected, the virulent organisms penetrate 
from the acini into the interstitial tissue, and from this time onwards 
the lesions become mixed. 

Inversely, should infection originate in the lymphatic spaces, a 
time arrives when the organisms make their way from the interstitial 
tissue into the acini, with a similar result in the end. 

The development of the lesions may be arrested or may pass on to 
suppuration, or even gangrene, of the parenchymatous lobules. Cases 
happen in which infection is so rapid and severe that the successive 
stages cannot even be identified, and gangrene appears without any pre- 
liminary stages at all. Luckily the commonest forms are less serious. 

Symptoms. Acute mammitis is characterised by its sudden appear- 
ance, more or less acute general symptoms (dulness, fever, and loss 
of appetite), and variable local symptoms. When the practitioner is 
able to follow the development of the disease throughout, he may 
sometimes distinguish well-marked signs, which permit the two clinical 
varieties to be distinguished. 

A. Interstitial Mammitis. — This form, which might perhaps also 
be termed peri-mammitis when it primarily affects the subcutaneous 
lymphatic spaces, has also received the names of phlegmonous and 
lymphogenous mammitis. 

It is characterised by alarming general symptoms, and particularly 
by a rise in temperature of 2°, 4P, or even 5° Fahr., with all its con- 
sequences, such as loss of appetite, stoppage of rumination, acceleration 
of breathing and circulation, slight tympanites, constipation, and by 
the thrusting of the hind limb on the affected side away from the 
centre line. The animals groan when forced to move. 

These symptoms sometimes precede by a considerable interval the 
appearance of the local changes, which consist in painful swelling of 
one or two quarters, rarely of more. 

The peri-mammary subcutaneous tissue is infiltrated, oedematous, 
painful on palpation and preserves the imprint of the finger. The teat 
is tense, swollen, very tender, and of reddish colour; In the grave 
forms the swelling extends forwards under the abdomen in the direc- 
tion of the umbilicus, and backwards towards the perineum. The local 
temperature is abnormally high, the secretion of milk in the diseased 
gland is modified or checked, and sometimes this phenomenon extends 
by reflex action to the neighbouring quarters, although the latter may 
not themselves be affected. The inflammation rarely extends from one 
quarter to another, because the lymphatic plexuses do not anastomose 
(Fig. 237). 



ACUTE MAMMITIS. 575 

The animals lose appetite and fall away rapidly. 
Eesolution may occur after from five to eight days. By degrees 
all the symptoms then become less marked. The appetite returns, 
pain diminishes, the fever drops, and the lesions gradually disappear, 
but the yield of milk rarely regains its former amount. 

Suppuration may occur ; sometimes a superficial subcutaneous 
abscess forms, more rarely, a deep-seated, interstitial abscess, originat- 
ing in the connective tissue or lymphatic spaces. With a superficial 
abscess, the local symptoms again revive to a slight extent ; these are 
present in a more marked degree where the abscess is deep-seated. 
An extremely sensitive oedematous swelling forms, the skin covering 
which is at some point of a deep -red tint, whilst fluctuation gradually 
appears. 

In cases of deep-seated abscess formation the general condition 
becomes alarming ; the affected quarter is tense throughout, hard and 
very sensitive. 

Deep-seated suppuration is difficult to detect, and exploratory 
punctures with a fine needle may be necessary before the diagnosis 
can be made. 

Local or diffuse gangrene forms a rare complication. It is due to 
the vessels of one or several glandular lobules becoming obliterated 
or thrombosed. 

Such a termination is indicated by extreme aggravation of the general 
symptoms, feebleness of the heart and great weakness of the patients, who 
fall into a condition of coma. Locally the udder remains oedematous, 
the skin becomes of a blackish-violet colour, whilst the local temperature 
falls and the animals die from exhaustion and intoxication. 

Parenchymatous Mammitis. — Parenchymatous mammitis when 
mild is also termed catarrhal mammitis. It is in reality true 
primary mammitis ; interstitial being primarily and practically peri- 
mammary lymphangitis. 

In this case infection occurs through the teat, and may be localised 
in the sinus or excretory apparatus, giving rise to galactophoritis, but 
it usually extends to the acini. Inflammation of the mammary tissue 
is therefore direct and primary. It rapidly extends, however, through 
the glandular wall into the interstitial tissue, thus setting up (from 
the anatomo-pathological standpoint) a mixed mammitis. Clinical 
distinction between this form and interstitial mammitis is at first 
easy. 

The symptoms usually occur in the following order : — Swelling of 
the affected quarter or quarters ; appreciable increase in size and 
sensitiveness ; the presence at first of curdled milk in the galacto- 
phorous sinus, then of clots mixed with slightly red tinged serosity; 



576 DISEASES OF THE MAMMARY GLANDS. 

complete cessation of the yield of milk, and suppm^ation in the 
secreting portions of the gland. 

The general symptoms appear only after the objective signs, and 
vary greatly in intensity, according to the case. As in the interstitial 
form, there may be marked fever, loss of appetite, cessation of rumi- 
nation, groaning, and difficulty in walking. 

In some grave forms, where development is peracute, infection 
spreads rapidly from the glandular to the interstitial tissue, and 
subcutaneous, sub-abdominal, or perineal interstitial oedema occurs 
secondarily. 

The udder is turgid, tense, shining, and of reddish-violet colour in 
places, as if a deep-seated abscess were developing. 

Pressure on the galactophorous sinus causes the flow of reddish-grey 
milk, sometimes foetid or of gangrenous odour. The animals seem 
exhausted, show signs of profound intoxication, are unable to rise, and 
appear paralysed. 

But besides these grave forms are others, in which the patients seem 
scarcely to suffer : appetite is preserved and all the vital functions are 
in full activity. Only the local signs are of importance. 

This variability in the clinical symptoms of acute forms of mammitis 
is entirely due to differences in the pathogenic infecting organisms. 

Parenchymatous mammitis may end in resolution in three to four 
days, with progressive but slow return to the physiological condition. 
This termination is announced by the gradual disappearance of all 
the symptoms and the return of milk secretion. It is, however, quite 
exceptional for the former condition to be fully restored, and in many 
cases the affected quarter must be regarded as lost from the physio- 
logical standpoint. 

It gradually becomes hardened, sclerotic and atrophied. 

Suppuration is very common. It attacks the galactophorous sinus, 
the excretory canals, and even the acini. If obstructions occur in the 
course of the collecting vessels, or if evacuation is not artificially 
stimulated by milking, the pus collects in the depths of the gland, 
and enormous diffuse abscesses may form at the expense of the 
mammary tissue. 

Circumscribed or diffuse gangrene, as a primary condition, is rarer. 
Infective organisms rapidly invade even the depths of the gland, the 
interstitial and subcutaneous tissue, and thrombosis due to infection 
or intoxication occurs, followed by gangrene. Death results from 
infection or intoxication. 

Complications such as necrosis of the abdominal tunic, of the 
fibrous tissue enveloping the mamma, and of the muscular layers on 
the inner surface of the thighs, may occur in the su|)purative forms. 



Acute mammitis. 577 

Diagnosis. The diagnosis of acute mammitis is easy, and the inter- 
stitial forms (mammary lymphangitis) can be distinguished from the 
parenchymatous forms very early in the attack. 

Careful examination suffices to differentiate between this condition 
and mammary congestion or primary chronic mammitis. The exami- 
nation, however, must be much more thorough and searching when a 
specific disease (such as tuberculous mammitis) is in question. 

Prognosis. The prognosis of acute mammitis is always grave, 
whatever form the disease may assume, for, if the animal's life is. not 
invariably endangered, its economic value is always affected. More- 
over, should superficial or deep-seated abscesses form, prolonged 
suppuration may follow, resulting in loss of condition and enormous 
depreciation. 

Lesions. The lesions of interstitial mammitis are similar to those 
of ordinary lymphangitis, the condition originating near the teat and 
gradually extending to the layers of connective tissue between the 
acini, mammae, etc. 

In the parenchymatous form the inflammation may remain partial, 
and be localised in particular tracts of glandular tissue. The secreting 
epithelium, when infected, exhibits cloudy swelling, becomes loosened, 
and disappears ; the margin of the gland and the interstitial divisions 
become infiltrated with enormous numbers of white blood corpuscles, 
and are the seat of suppurative processes which end in the production 
of small acinous abscesses. By the union of neighbouring abscesses 
large branching collections of pus are produced, and lead to partial or 
total destruction of tracts of the parenchyma, of the connective tissue 
divisions, vessels and aponeuroses. 

The abscess tends to break through the skin, which becomes inflamed 
and ulcerated, or, when the micro-organisms are of slight virulence, the 
tissues may react, so that the abscess becomes surrounded with a thick 
indurated wall, and finally encysted. 

Treatment. Very numerous methods of treatment have been pro- 
posed, an admission which, in itself, suggests that no perfect one has 
been discovered. No infallible system, in fact, exists of arresting the 
disease and restoring the parts to their normal condition. 

From a prophylactic standpoint, mammitis can be avoided by placing 
the animals under proper hygienic conditions, paying special attention 
to cleanliness, avoiding over-stocking, and treating excoriations or in- 
juries to the teat or udder as soon as they appear. 

Once acute mammitis has developed, general and local treatment 
must both be attempted. 

The older practitioners were in the habit of bleeding from the 
mammary or jugular vein. Since their time, however, objections have 

D.C. P P 



578 DISEASES OF THE MAMMARY GLANDS. 

been made to bleeding because acute mammitis has been proved to be 
of an infectious character, and, therefore, it is undesirable to lower 
the patients' resisting power. 

This reasoning, however, appears to be erroneous. Little by little 
the advantages of bleeding, both in intoxications and infections, have 
been recognised, and one thing at least is beyond dispute, namely, its 
action on fever. Undoubtedly, it must not be resorted to without 
judgment, nor should it be freely employed in debilitated animals ; 
but in well-nourished patients its effect on fever and on the accom- 
panying respiratory and circulatory disturbance is immediate. 

We, therefore, recommend moderate bleeding from the jugular. 

Bleeding from the mammary vein entails too great a risk of infection 
to be commendable. 

Purgatives and diuretics diminish or prevent accidents such as 
intoxication and the complications resulting from temporary suspen- 
sion of the digestive function. 

Local treatment is more or less efficacious in mammary infection. 
To relieve pain and check infection it should be of an emollient and 
antiseptic character. Ointments containing 10 per cent, of carbolic 
acid, boric acid or iodine, or 12J per cent, of camphor, opium or 
belladonna, are of real service during the first stages, particularly of 
mammary lymphangitis and interstitial mammitis. 

Kepeated applications of 10 per cent, carbolic-glycerine have similar 
advantages. 

In the less acute forms originating in the parenchymatous tissue, 
mild ointments of plumbic iodide, Goulard's extract, or mercury 
may also be used if precautions are taken to prevent the animals 
from licking, and so poisoning themselves. 

When the tendency to suppuration is marked, vesicants hasten 
the development of the abscess and facilitate puncture. The most 
commonly used are the 33 per cent, tartar emetic ointment or the 
10 per cent, biniodide of mercury ointment. 

If, on the other hand, the mammitis is of the interstitial type, 
with severe subcutaneous oedema, extending over the belly and 
towards the perineum, good results often follow deep firing in points 
over the swollen region. The points should be widely spaced, venous 
branches being avoided. In this way numerous ducts are formed by 
by which the toxic and septic liquid which causes the oedema is enabled 
to escape. 

This method of treatment can be supplemented by the simultaneous 
use of antiseptic ointments. 

Finally, in mammitis of the parenchymatous type, where there 
is no marked tendency to invade the interstitial tissue, the most 



ACUTE MAMMITIS. 579 

important point is to wash out the interior of the gland, and even 
the acini as far as possible, with antiseptic fluids. Practically this is 
difficult to effect, because such irrigation must be performed asepti- 
cally, and cannot properly be left to the cowmen. 

In current practice, therefore, one often has to be content with 
stripping the udder every hour. Milk clots which accumulate in the 
sinuses and galactophorous canals are broken down by soft pressure, 
and withdrawn with more or less difficulty. By repeated milking they 
are prevented from accumulating in the galactophorous sinus and canals, 
a very important point. Neglect of this precaution enables the colonies 
of micro-organisms to develop uninterruptedly in the culs-de-sac, where- 
upon the coagula formed of caseine obstruct the excretory channels and 
complications develop despite all external treatment. 

By repeated friction of the udder as in milking the advantages 
that would be produced by washing out the gland from the direction 
of the acini are secured, and thus the ascending infection is checked. 
The diseased udder must always be emptied before making anti- 
septic injections, which would otherwise be useless. 

Should the practitioner decide to face the practical difficulties of in- 
jections, he must take care that his instruments are aseptic ; that the 
solutions employed are always at or about bodily temperature ; that 
these solutions are incapable of irritating even tissues so tender as the 
epithelium of the acini or of the galactophorous canals ; and, finally, that 
the drugs employed will not coagulate the milk within the gland. 

Bearing in mind these points, the practitioner will do well to re- 
strict himself to the use either of boiled water, physiological salt 
solution ('9 per cent.)"; alkaline 3 per cent, solution of borate of soda; 
or "05 per cent, of fluoride of sodium. Every precaution having been 
taken, from 12 to 20 ounces of liquid can be injected into each 
quarter, according to its size. The solutions should be made to jDene- 
trate as far as possible into all portions of the gland by gently 
manipulating the parts, and should again be withdrawn in about a 
quarter of an hour. 

It must always be remembered that failure to observe the above 
precautions may make matters worse . instead of better, and therefore 
that intra-mammary injections can only be of value when carried out 
by a skilled person. 

In otherwise hopeless cases there remains as a last resort total or 
partial ablation of the mamma. This operation is advisable in cases 
of diffuse gangrene, or of intense massive suppuration, where there is 
imminent danger of death from infection. 

Directions for its performance will be found in MoUer and Dollar's 
"Eegional Surgery" (uniform with the present volume), p. 454. 

PP 2 



580 DISEASES OF THE MAMMARY GLANDS. 

CONTAGIOUS MAMMITIS IN MILCH COWS. 

Although its cause was unknown before the investigations of 
Nocard and Mollereau in 1884, this disease is of very common 
occurrence in England, in large dairies in the environs of Paris, and 
is also seen, though more rarely, in Normandy, in Brie and the Soisson- 
nais, causing serious losses on account of its transmissibility. 

It had been described in Germany by Gerlach as early as 1854, 
and Kitt in 1885 recognised it as common, and proposed for it the 
title of "contagious catarrhal agalaxia." It also occurs in Denmark, 
Italy, and England. 

Contagious streptococcic mammitis of cows always assumes a chronic 
form, during the course of which indurated centres appear, varying in 
size between that of a hazel-nut and a walnut. 

Causation. The cause is always to be found in contagion, the 
disease being due to a streptococcus, which has been carefully studied 
by Nocard. Its transmission from a diseased to a healthy udder is ex- 
plained by the fact that the milkers are careless as to cleanliness, and 
thus directly convey the germs to healthy teats and facilitate infection. 

Symptoms. As in chronic mammitis, general symptoms are not 
well marked, though some cases are ushered in with cough, slight 
nasal discharge, and offensive diarrhoea. The first appreciable indi- 
cation is a change in the milk, which diminishes in quantity, and, 
although normal to all appearance, coagulates rapidly if left undis- 
turbed. Infection has already taken place, although nothing can be 
detected on examining the udder. 

Next appears a nodule of hardened tissue above the teat. This 
nodule is of rounded or ovoid shape, ill-defined towards its periphery, 
and it becomes progressively enlarged without any sign of acute 
inflammation. The milk becomes watery and of a bluish colour. 
Microscopical examination reveals numerous streptococci. The harden- 
ing process proceeds slowly. At the end of several months the 
sclerosis may only have extended to one-third of the height of the 
infected quarter. With the appearance of these lesions the character 
of the milk again changes. It becomes yellowish in colour and foetid, 
and contains a fibrous reticulum, whilst its reaction is distinctly 
acid. The lesions, which at first had been confined to one quarter, 
successively extend to the others unless precautions are taken. 

Lesions. The lesions consist in mammary sclerosis, with nodules 
which progressively increase in size. This sclerosis originates in the 
galactophorous canals, and extends first to the periphery, then to the 
interstitial connective tissue ; the latter undergoes hyperplasia and 
confines within its tracts the true glandular elements, destroying 
their secretory power. Locally, catarrhal mammitis exists. 



CHRONIC MAMMITIS. 581 

The lesions can easily be recognised on microscopic examination, 
and, when the section is suitably stained, numerous streptococci can 
be detected in the acini, which are blocked with proliferating epi- 
thelial cells. These lesions are due to the invasion of colonies of 
micro-organisms, W'hich spread from below upwards. 

The streptococcus causing this mammitis colours readily with 
thionin and methylene blue. It can be cultivated in liquid and 
solid media containing sugar or glycerine, but growth is impeded by 
the presence of peptone or common salt. Under ordinary circum- 
stances the culture dies after some w^eeks, but if the acidity of the 
medium is neutralised by the addition of powdered carbonate of 
lime, it preserves its vitality for six or eight months. The culture 
when injected into the udder of a healthy cow or she-goat reproduces 
the disease. The micro-organism is not pathogenic for any of the 
smaller animals used for purposes of experiment. 

Diagnosis and prognosis. The diagnosis is easy, the presence of 
the sclerotic nodules being characteristic, w^hilst in doubtful cases a 
microscopical examination can always be made. 

The treatment should be prophylactic and curative. 

Prophylactic treatment comprises disinfection of the milkers' hands, 
which are the ordinary vehicles of contagion, and disinfection of the 
cow's udder. Diseased animals in a byre should be milked last of all, 
and the milk should be destroyed. 

Curative treatment is confined to local antiseptic injections. Warm 
concentrated boric solution gives good results. The injections may be 
repeated thi'ee or four times a day after milking, the liquid being left 
for a certain time within the udder. In this way animals suffering 
only from a slight attack may be cured, but when the disease is 
already somewhat advanced injections lose their effect. 

Injections of* fluoride of sodium ('1 to '5 per cent, strength) 
appear to be much more effectual. Moussu claims to have cured by 
this means several old- standing cases where all four quarters of the 
gland were diseased. 

These injections necessitate the same precautions as those above 
indicated for securing perfect asepsis. In grave cases it is ver}^ diffi- 
cult to prevent the disease from extending in infected stables, because 
the necessary precautions cannot be observed. 

CHRONIC MAMMITIS. 

Chronic inflammation of the udder may form a termination of 
ordinary acute mammitis, or it may result from infection with or- 
ganisms of a less virulent type. 



582 DISEASES OF THE MAMMARY GLANDS. 

In cases of acute mammitis, where severe injury of the interstitial 
tissue or mammary parenchyma has occurred, its physiological func- 
tion is partially destroyed. The circulation is disturbed, the vessels 
undergo change, the layers of connective tissue are indurated and 
sclerotic, the epithelial tissue is not fully restored, and chronic 
inflammation of the udder persists. 

Clinically, it is impossible to distinguish all the variations that 
may occur, because the constituent tissues are all injured, and the 
disease is of a mixed type, with very numerous variations. 

Symptoms. When chronic mammitis follows the acute form its 
onset is only indicated by gradual diminution in the signs of acute 
inflammation. The appetite is regained, and all the important vital 
functions are properly performed. 

Nevertheless, it is possible to distinguish two different clinical 
forms. In one, the secretion of milk is almost entirely suspended, 
the udder becomes atrophied, shrivelled and sclerotic ; the hardening 
gradually continues, and the patients, being useless as milch cows, 
can only be fattened for slaughter. The induration may be partial, 
nodular, or diffused. 

In the other form the udder is large, but the milk is replaced by 
a purulent secretion which permeates the acini and galactophorous 
canals. Although they eat well, the patients remain thin, and are 
with difficulty fattened for slaughter. 

The suppuration may be diffuse or local. In rarer cases it is 
localised in the form of " cold abscess." 

Treatment. No treatment can perfectly restore the udder after 
chronic mammitis with sclerosis and atrophy. 

In the suppurating forms of chronic mammitis the morbid secre- 
tion may be checked by internal irrigation of the udder and antiseptic 
injections, but, as this treatment necessitates careful and continued 
attention, it is usually out of the question. 

If only one quarter is diseased the animal may be kept for milking 
purposes, but where two or three quarters are attacked it should be 
prepared for the butcher. 

In cows suffering from chronic purulent mammitis of all four 
quarters, Kroon suggests removing the teats in order to facilitate 
fattening. The teats are removed with the bistouri or scissors, by 
which means a large opening into the galactophorous sinus is pro- 
duced, through which the purulent secretion escapes freely and 
continuously ; the retention of pus and intoxication in consequence of 
resorption are prevented and the animal can be fattened, which would 
be difficult without the operation. 



GANGRENOUS MAMMITIS OF MILCH EWES. 583 

GANGRENOUS MAMMITIS OF MILCH EWES. 

This disease occurs in different parts of France, and has also been 
seen in Germany. 

Causation. Lafosse in 1856 attributed it to the dark and dirty 
condition of the sheep-folds, a cause which certainly contributes to 
its propagation, though it is not the determining cause of the disease 
itself. The latter is a specific micrococcus discovered in 1875 by 
Kivolta, and thoroughly studied by Nocard in 1886 and 1887. 

Symptoms. The course of the symptoms offers a certain analogy 
to that of septic engorgements and interstitial mammitis or mammary 
lymphangitis. As a rule only one gland is infected, but generally 
symptoms at once appear, indicating an extremely dangerous condition, 
viz., peracute mammitis. The patient suddenly becomes dull and 
entirely loses appetite, rumination ceases and respiration is short 
and jerky, although the bodily temperature does not always rise to any 
marked extent. 

Local symptoms soon develop. The udder assumes a violet-red 
tint and becomes the seat of an erysipelatous swelling; the local tem- 
perature rises, but as the disease progresses it gradually falls again. 
Milk secretion ceases. 

All these appearances rapidly become aggravated. The patient lies 
down ; the oedematous swelling extends to the belly and even to the 
chest and thighs ; the local temperature falls, indicating the immi- 
nence of gangrene ; the teat becomes contracted, and the pulse is very 
frequent and almost imperceptible. From time to time the animal 
grinds its teeth. 

The bodily temperature next falls to 98° or even 96 °Fahr. (37° or 
36° C), and the animal shows extreme prostration. The subcutaxieous 
swelling extends as far as the sternum in one direction and the 
quarters and perineum in the other. The udder crackles under the 
finger. Death occurs without a struggle. 

All these symptoms follow as a rule in barely more than twenty- 
four hours. Nevertheless, in certain cases, the disease lasts for three, 
four or five days. Cases of spontaneous recovery are exceptional. 
The gangrenous part may become delimited and slough away, leaving 
an enormous suppurating wound, which slowly cicatrises. Even 
though the animals survive, they never recover condition, but remain 
weakly, so that, from a monetary standpoint, death would have been 
preferable. Moreover, the lambs are starved and require a foster- 
mother. 

Lesions. Post-mortem examination reveals oedematous infiltration 
of the udder and surrounding connective tissue, and often extensive, 



584 DISEASES OF THE MAMMARY GLANDS. 

diffuse gangrene. The serosity is of a reddish colour, and sections 
of the diseased udder of a violet tint. The tissues of the udder and 
the serous liquid contain the specific micrococcus. 

It is very small, and stains readily by the Gram-Nicolle method. 
It grows rapidly in liquid and solid media, liquefies gelatine, and 
quickly renders neutral media alkaline. 

The injection of a few drops of culture into the udder of a milch 
ewe reproduces the typical disease. In any other species it is with- 
out effect. Infection occurs through the open extremity of the teat, 
or the medium of a wound, and the micro-organism is so virulent 
that it rapidly invades all the tissues. 

Treatment. No antiseptic treatment appears capable of checking 
the course of the disease. 

Surgical treatment alone is of any value, and consists in ablation 
of the udder, followed by antiseptic dressing. Only a portion of the 
gland is removed : an elliptical incision is made, including the diseased 
teat, the skin is then dissected free so as to form a flap ; the diseased 
tissue is isolated ; last of all, the vessels are ligatured. The conse- 
quences of operation are less grave than might be expected, consider- 
ing the size of the wound, which heals with fair rapidity. 

Moussu has frequently practised this radical method of treatment 
without losing a single case. The remaining portion of the udder 
becomes hypertrophied, and is often quite capable of secreting suffi- 
cient milk for the nourishment of one lamb. 

GANGRENOUS MAMMITIS IN GOATS. 

Goats suffer from a form of mammitis which presents symptoms 
precisely similar as regards development and termination to that 
of ewes. The disease occurs in a sporadic form in animals giving 
milk, whatever their breed or the conditions under which they are 
kept. It has been seen at Alfort, as well as at Lyons. 

Moussu has seen it in an enzootic form in herds of milch goats 
near Bizerta (Tunis), and considers that contagion results from kids 
sucking healthy animals after having been suckled by diseased ones. 
Fifty milch goats out of a total of three hundred were affected at 
the time of Moussu's visit, and two had already succumbed. 

The diagnosis presents no difficulty. 

The prognosis is very grave. 

The treatment is precisely similar to that of gangrenous mammitis 
of milch ewes, viz., ablation of the diseased udder. 

Of the above-mentioned herd, twenty animals were ojDerated ' on, 
and all recovered without accident. Among the others treated by less 



TUMOURS OF THE UDDEE. 585 

radical methods, such as scarifications, incisions, antiseptic injections, 
etc., eight died. The only justifiable treatment, therefore, is ablation. 

CYSTS OF THE UDDER. 

Cj^sts of the iidder may assume one of two forms, milk or galactoce- 
lous cysts and serous cysts; possibl}^ the latter are only hydatid cysts. 

Both varieties are of the nature of retention cysts, and result from 
accidental obliteration of a milk conduit, which has been obstructed 
by coagulated casein, or from atresia due to contraction of inflamed 
connective tissue. The acini are isolated and become dilated, the milk 
undergoes changes in composition, the secretory epithelium degenerates, 
and the cyst is produced. 

The serous or milk cysts may vary considerably in size, and always 
show a rapid tendency to suppuration. 

The diagnosis is based on the detection of uniform fluctuation 
without excessive sensibility, and can be confirmed by an exploratory 
capillary puncture. 

The prognosis is grave, for recovery can only occur after the lining 
membrane of the cyst has been destroyed. 

Treatment. Puncture followed by irrigation is insufficient, whatever 
the nature of the cyst. 

Free incision, or simple puncture with a bistoury, produces sup- 
puration within the cystic cavity, which continues until the lining 
membrane is completely destroyed ; but this takes a very long time. 

Eemoval of the entire cyst, either with the bistoury or by tearing 
through the surrounding connective tissue, is the best method of treat- 
ment. The wound thus produced heals regularly and rapidly under an 
antiseptic surgical dressing. 

TUMOURS OF THE UDDER. 

Tumours of the udder have been little studied in the larger 
domestic animals, the reason being that immediately animals cease to 
yield milk they are fattened and despatched to the butcher. Clinically, 
therefore, these tumours are not of great practical importance. 

Without entering into general considerations of a pathological 
anatomical character, by which different varieties of these tumours are 
difterentiated, we may say that they assume one of three different 
forms. The first is sharply circumscribed, of clearly defined shape, and 
easily separated from neighbouring tissues, to which it adheres but 
slightly. Such tumours are benign, and have no tendency to return 
after removal. 

The second is ill-defined, very adherent, and appears to infiltrate 



586 DISEASES OF THE MAMMARY GLANDS. 

the surrounding tissue. It is malignant in character, is often impossible 
to completely remove, returns after extirpation, and infects neighbouring 
lymphatic glands. 

Between these two varieties may be placed a third, occupying an 
intermediate position as regards both its characteristics and gravity. 

Practically a knowledge of the above facts is a sufficient guide in 
dealing with lesions of this character. 

Canalicular Papillomata. — There exists another variety of tumours 
which is of much more frequent occurrence, and which is apt to cause 
mistakes. This variety consists of inter-canalicular papillomata. 

These show no sign of their existence on external examination of 
the diseased udder, and can be diagnosed only by reasoning based on 
the signs observed. 

They are of very small size, and grow from the internal wall of 
the galactophorous sinus or excretory canal. They increase in length, 
finally extending for some distance along the sinus, where they remain 
unrecognised until some external manifestation arouses suspicion as to 
their existence. 

Under the mechanical contraction due to milking they easily become 
excoriated, and their existence is then suggested almost solely by the 
fact that the milk is tinted with blood, for palpation of the udder very 
seldom gives more than negative results. 

The diagnosis is always doubtful. The prognosis is grave, because 
it is impossible to remove the tumour, which is often deeply placed 
within the udder. There is no curative treatment. 



VERRUCOUS PAPILLOMATA OF THE UDDER. 

In cows suffering from cutaneous papillomata the udder is often 
covered with a varying number of little sessile warts, which are spread 
over a considerable surface, are very sensitive, and bleed at the lightest 
touch. Milking is thus rendered extremely painful and difficult ; the 
animals struggle, kick, and become dangerous. 

The condition is extremely troublesome, and in spite of every pre- 
caution the milk is always soiled. 

The best method of treatment consists in removing the warts 
individually with fine, sharp-bladed curved scissors. 

The animals must be firmly secured, if necessary cast, and the 
operator should avoid removing more of the skin covering the udder 
than is absolutely necessary. The bleeding which follows is trifling, 
and stops of itself. After washing the parts with an antiseptic solu- 
tion, the little wounds may be powered with a mixture in equal 
proportions of tannin and boric acid. 



CHAPTER VI. 

DISTURBANCE IN THE MILK SECRETION AND 
CHANGES IN THE MILK, 

Changes in the milk are so common and play so important a part 
in the milk industry that it is absolutely necessary to mention the 
more important, the country veterinary surgeon being frequently con- 
sulted on this point. 

The udder acts as a natural emunctory, just like the kidney, by 
which are eliminated, in consequence of special selective properties, 
certain natural principles (the active principles contained in the forage 
and other food, vegetable alkaloids, etc.), drugs (alcohol), and poisons 
(nicotine). This physiological peculiarity explains the influence of 
changes of diet on the composition of the milk in mothers and on 
the condition of their offspring. In the human species it also explains 
congenital alcohoHsm in children, and a number of diseases whose 
cause was formerly unknown. 

Agalaxia.— This term implies a temporary or definite arrest of 
the milk secretion. In many instances it represents nothing more 
than a disturbance in the physiological function of the gland, but m 
others it forms a true diseased condition. 

Thus it is beyond dispute that psychical influences may produce 
disturbance in this respect. Temporary suspension in the secretion as 
a consequence of removal of the offspring from its mother, especially 
when the young animal has been sucking for several days or weeks, 
is a fact very well known to all breeders. 

Under ordinary circumstances, however, the reasons are quite 
different, and when the secretion of milk is diminished or suppressed 
it is due to the ingestion of plants, substances, or drugs which check 
the secretion of milk. All the solanaceee (belladonna, hyoscyamus, 
stramonium, woody nightshade, etc.), certain umbelliferEe (hemlock), 
colchicum, etc., have this effect. 

As to agalaxia of a true pathological character, it occurs in debiU- 
tating and grave diseases, and sometimes follows certain contagious 
forms of mammitis complicated with sclerosis of the udder (infectious 
agalaxia of goats). 



588 DISTURBANCE IN THE MILK SECRETION AND CHANGES IN THE MILK, 

Diagnosis, The diagnosis of agalaxia presents no difficulty. 

Prognosis. The prognosis varies, according to the determining 
cause. In cases of accident and in temporary agalaxia, it is sufficient 
to change the food in order to restore the secretion. Cooked food 
and warm drinks, with an allowance of roots such as turnips or man- 
golds, have excellent results. Where restoration of the secretion is 
delayed the use of what are called galactogogues has been recommended, 
comprising fennel, carraway, cummin, aniseed, juniper, sulphur, etc., 
mixed in equal parts and given in doses of 6 to 8 drachms per day for 
a cow. 

They act principally through the stimulating effects of their aromatic 
principles. 

MICROBIC CHANGES IN MILK. 
LACTIC FERMENTS. 

Microbic changes in milk are much commoner than changes of a 
chemical nature. Milch animals differ very markedly one from another, 
and, according to circumstances, give milk of ordinary composition, 
milk of a very rich character, or watery milk ; but the most important 
changes in composition are those due to microbic agents. 

During the milking, and according to whether this is performed in a 
low, dirty byre, in a clean, roomy byre, or in the open air, various 
numbers of germs obtain entrance to the milking vessels, and develop 
there with extraordinary rapidity. The milk may even become infected 
by non-pathogenic germs while still within the udder, in the sinus and 
galactophorous canals. The cleanhness of the milking vessels also has 
a considerable influence on the number and variety of the microbes 
which may eventually germinate in the liquid. 

Among the micro-organisms usually found in milk there are some, 
however, which always preponderate and play the part of organised 
ferments, viz., the lactic ferments and the organisms which cause co- 
agulation of the casein ; these may be regarded as normal constituents. 
The others are more or less foreign, and may cause important changes 
in the milk or cream. 

The lactic ferments are numerous, comprising the lactic bacilli of 
Hueppe and Grotenfeld, the micrococci of Hueppe and Marpmann, and 
the bacilli and micrococci of Freudenreich. These different agents act 
on the lactose of the milk, decomposing it into carbonic and lactic 
acids, which coagulate the milk. 

Another group of micro-organisms which were well studied by 
Duclaux comprises those acting on the casein, among others Tyrothrix 
tenuis, filiformis, turgidus, scaher, virgula, etc. 

These organisms secrete principles having similar effects to those of 



MICROBIC CHANGES IN MILK. 589 

rennet, and are capable of coagulating enormous quantities of milk. 
After a certain time, they also secrete a second diastase, viz., casease, 
which acts in the ripening of cheese. 

Clotted Milk. — This term is used in dairies to indicate milk which 
coagulates in lumps immediately after being withdrawn from the udder, 
or which coagulates spontaneously a few hours later. 

The change may be of a chemical nature, depending on conditions 
of keep or feeding. More frequently, however, it is related to a latent 
non-pathogenic infection of the udder, or to immediate infection of the 
milk after removal by lactic ferments contained in the milk vessels or 
the atmosphere. 

It is necessary, according to circumstances, either to modify the diet 
or disinfect the milk vessels, and immediately pasteurise the milk. 

Milk without Butter. — Less commonly the diseased condition is 
indicated by marked diminution in the quantity of cream. 

Churning only produces a poor kind of butter, particles of which do 
not readily cohere. This peculiarity is due to the presence of micro- 
organisms, which have not yet been fully identified. It can be prevented 
by disinfection of the milking vessels, as well as of the dairy itself, and 
by the use of centrifugal separators. 

Putrid Milk. — This milk is characterised by its odour. It cannot be 
used for making butter. In fact, as soon as the cream separates, little 
bubbles of gas form at various points and break, leaving small cavities. 
These little separate cavities reunite very rapidly, and the cream becomes 
reabsorbed as fast as it is formed. Afterwards oily drops formed of 
butyric, capric, and caprylic acids appear in the depressions and give 
the milk a repulsive odour (rancidity). 

This change is seen during mammitis, but most commonly results 
from uncleanliness in byres and dairies. In the latter case j)ntrefaction 
occurs about twenty-four hours after milking, and is due to the growth 
in the milk of Bacterium tenno, lineola, etc. These organisms are pre- 
sent in the dust which falls into the milking pails in the byre ; when 
milk so contaminated is stored in the dairy the changes occur. 

Putrid odour may also be due to the presence of ammoniacal gas 
in the byre, or to special toxins liberated by microbes which have found 
their way into the milk. It is most marked during the warm seasons of 
the year. 

The occurrence of putrid milk can be prevented by disinfecting the 
dairy and the milking pails daily for a certain time. 

Mucous, viscous, or thready Milk. — These terms are applied to a 
condition which usually appears twenty-four or thirty-six hours after the 
milk has been withdrawn. The milk seems thick and viscous, and can 
be drawn out into threads like mucus. It sticks to neighbouring objects. 



590 DISTURBANCE IN THE MILK SECRETION AND CHANGES IN THE MILK. 

and adheres to milk vessels like molasses. It coagulates imperfectly 
on standing, gives little cream, and even this cream only furnishes a 
mawkish, ill-flavoured butter. 

In certain parts of Switzerland the production of mucous milk is 
favoured, because it is employed in making cheeses. 

The change is due to the presence of various micro-organisms. 
Those which have been best studied are Schmidt-Mulheim's micrococci, 
the Actinobacter polymorphus of Duclaux, the Bacillus lactis pituitosi of 
Loffler, the Bacillus lactis of Adametz, the Streptococcus hollandicus, and, 
finally, three others which are much commoner, Guillebeau's bacillus, 
the Micrococcus Freudenreichii, and the Bacterium Hessii. These micro- 
organisms act on the lactose, decomposing it and causing the formation 
of a kind of filamentous mucilage, which can be isolated by the addition 
of alcohol. 

The mucilaginous change in milk can be prevented by ordinary 
methods of disinfection. 

Red Milk. — Milk which becomes red some hours after withdrawal, or 
within forty-eight hours after milking, should be distinguished from 
milk which on withdrawal from the udder is tinted red in consequence 
of haemorrhage within the udder itself. When the milk is of a haemor- 
rhagic tint the blood corpuscles are soon deposited on the bottom of the 
vessel if the milk is allowed to remain undisturbed. 

The tint which the milk assumes is due to the growth of chromogenic 
organisms, the best known of which are as follows : — 1. B. prodigiosus, 
which produces large red patches on the surface. It grows readily on 
potato and gelatine, which it liquefies. 2. The Sarcina rosea, which 
develops first of all in the cream and afterwards invades the milk. It 
grows in sterilised milk, on alkaline potato, and on gelatine. 3. The 
Bacterium lactis erythrogenes, which liquefies gelatine and produces a 
reddish coloration. Casein can be precipitated and peptonised by means 
of its cultures. It develops in the milk below the cream, the serum 
alone becoming red, and only when shaded from the light. 

Blue Milk. — In this case the milk appears normal when withdrawn, 
but some days afterwards shows blue patches, which gradually increase 
in size, and by uniting produce a distinct blue tint at the surface. 

This change is connected with the presence of the B. cyanogenus. 
The organism grows in sterilised milk, but in this case merely produces 
greyish patches, the blue tint only occurring when a certain quantity of 
lactic acid is added or when the ordinary lactic ferments are present. 

Yellow Milk. — A yellow tint occurs in ordinary milk and cream, 
particularly in certain breeding districts — in Normandy, for example, 
where the butter produced is greatly valued on account of this ap- 
pearance. Pathological yellow milk is the result of the growth of 



MICROBIC CHANGES IN MILK. 591 

B. synxanthus Schroter, which secretes a substance resembhng rennet, 
curdles the milk, and finally dissolves the clot, at the same time 
producing the yellow colour. 

Bitter Milk. — Milk which is of a normal character on being with- 
drawn from the udder may acquire a bitter taste some hours later. At 
rest, this milk produces a small quantity of yellowish, frothy cream. 
The organisms which produce the change have been studied in Ger- 
many, Switzerland, and Auvergne. We may mention Weizmann's 
bacillus of bitter milk, Conn's micrococcus of bitter milk, and Duclaux's 
Tyrotlirix geniculatus. 

Medicated Milk. — Medicated milk may be divided into tw^o kinds : 
Firstly, medicated milk proper, which differs from normal milk inas- 
much as it contains a certain proi^ortion of drugs, which, when swallowed 
by milch cows are partly eliminated through the udder. When taken 
by a young animal or child such milk has a distinct therapeutic effect, 
depending on the principles employed. 

It does not appear, however, that up to the present any very great 
success has followed this system. It is possible to increase the richness 
of the milk in phosphates, but as regards mercurial or iodine prepara- 
tions the failure has been complete. 

Secondly, fermented milks, which in addition to their nutritive action 
are made more digestible. 

Fermented milk is easily digested, and is better borne by the weakest 
stomachs. 

In human practice the fermented forms of milk are two, viz., kej^hyr 
and koumiss. 

Kephyr is prepared in Afghanistan and Persia from camel's milk, 
but for some years past it has been made in England wdth cow's milk. 
A certain quantity of cow's milk is placed in a bottle and the ferment, 
consisting of kephyr grains, is added. The lactose is converted into 
carbonic acid and alcohol in consequence of the action of certain lactic 
microbes. 

This milk after ingestion does not require to be coagulated and then 
digested before absorption, a fact which considerably diminishes peptic 
digestion. 

Koumiss is a milk preparation resembling kephyr ; it is made by 
the Kirghizes with mare's milk according to the same principles, but 
the ferment employed gives more alcohol. 

Preservation of Milk. — On account of the importance of preserving 
milk for use in large towns, in hospitals, and in the army during war, 
the question of its preservation has long been studied. 

Chemical Processes. — The principle of preserving milk by chemical 
action consists in preventing, or at least retarding, the changes which 



592 DISTURBANCE IN THE MiLK SECRETlON AND CHANGES IN THE MILK. 

inevitably follow exposure to the air. For this purpose, chemical sub- 
stitutes are added which in themselves have no injurious action. Those 
most commonly employed are : — 



Carbonate of soda 
Bicarbonate of soda 
Boric acid . . 
Salicylic acid 
Borax 
Lime 



45 grs. per quart. 



45 grs. 

15 to 30 grs. 

. . 12 grs. 

60 grs. 

20 grs. 



The results obtained are of comparatively little value ; the milk only 
keeps for a few hours, or at the most for three or four days. 

Cold. — Kefrigeration, which is so valuable in preserving all kinds of 
animal products for long periods, has also been used for preserving 
milk. Unfortunately, although cold impedes the development of bacteria, 
it also has the grave inconvenience of causing the cream to separate 
from the milk, and it being impossible to mix them again satisfactorily, 
milk preserved in this way is more or less unfit for consumption. 

Heat. — The principle of preserving milk by heat is based on the 
destruction of the micro-organisms at a high temperature. In this 
respect again, one meets with obstacles, for, if the heat be applied 
direct, some of the principles of the milk are converted into caramel, 
and if the temperature rises beyond IST'^ Fahr. (70° C.) the com- 
position of the milk is changed. 

Preservation by Oxygen. — Within the last few years the use of oxygen 
at a pressure of about two atmospheres has been recommended. 
When the milk is to be used it is only necessary slightly to relieve the 
pressure and allow the oxygen to escape, the liquor which remains 
having all the characters and qualities of fresh milk. The method 
appears excellent, but is too costly for every- day use. 

Pasteurisation. — The pasteurisation of milk aims at destroying the 
greater proportion of the ferments above mentioned. The milk is 
heated at atmospheric pressure, and is kept for a time at a tempera- 
ture of between 150° and 157° Fahr. (65° and 70° C). It preserves 
its properties and composition, but sterilisation is not complete, and 
the milk cannot be kept indefinitely. 

Concentrated Milk. — Concentrated milk is obtained by prolonged 
heating to 157° Fahr. (70° C.) in a vacuum, when it becomes syrupy 
by evaporation and its composition is not greatly modified. It is 
then drawn off into bottles, which are hermetically sealed and sub- 
jected to a higher temperature to complete the destruction of all the 
germs. Condensed milk keeps for a very long time. To prepare it 
for use it is mixed with a certain quantity of water, and then yields 
a liquid similar to normal milk. 



MICROBIO CHANGES IN MILK. 593 

Sterilisation. — Sterilisation necessitates the use of special apparatus 
in which the milk is heated in a water or steam bath sheltered from 
the action of the air, the temperature rising to 212° to 240° Fahr. 
(100° to 115° C.) ; all the ferments are destroyed, and the milk will 
keep indefinitely, but its composition is slightly modified. 

Diseases Transmissible to Man through the Medium of Milk. — 
Tuberculosis. — The history of tuberculosis contains numerous facts 
proving the possibility of contagion by milk from cows suffering from 
tuberculous mammitis, though it seems necessary that the milk 
should be taken for a certain time to produce these effects. 

Foot-ancl-Mouth Disease. — Observations recorded by veterinary 
surgeons prove that this disease affects the teats. It may be trans- 
mitted to man. The milker may be directly inoculated, but the milk 
is the ordinary vehicle of contagion. Chauveau saw an epidemic in 
a school at Lyons where milk was obtained from cows suffering from 
foot-and-mouth disease. In a similar way 205 persons were inocu- 
lated at Dover in 1884, and suffered from vesicles about the mouth. 

Although foot-and-mouth disease is extremely benign in men, it 
is well to take every precaution against it. 

G astro-Intestinal Infections. — Cases have been recorded of gastro- 
intestinal infection in young animals and children in consequence of 
consuming milk which had undergone abnormal changes. Milk con- 
taining various kinds of micro-organisms may at first produce lactic 
indigestion and afterwards diarrhoeic enteritis. 



D,a Q Q 



CHAPTER VII. 
MALE GENITAL ORGANS^ 

The scrotum, the vaginal sheath, the testicles, the vas deferens, 
the vesiculse seminales, the prostate, and Cowper's glands may all 
become the seat of disease. 

The scrotum and testicles seldom reveal more than mechanical 
injuries of external origin, producing wounds and cuts and, in the 
case of severe contusions, haematoma of the scrotum, of the vaginal 
sheath, and of the testicles. Inflammation of the testicle, that is to 
say, traumatic orchitis, is rare ; on the other hand, Moussu has several 
times seen tuberculous orchitis, for which he has operated. This, 
however, was in the boar. These different lesions, the last named 
excepted, usually heal with rest and the application of antiseptic 
dressings, anodyne and resolvent lotions. 

Breeders seldom retain more entire animals than are strictly neces- 
sary for reproduction. The others are castrated, and this alone 
explains why the treatment of genital diseases in male animals of 
any species is rare. 

TUMOURS OF THE TESTICLE. 

. Of the genital diseases which possess real clinical interest the 
most important are tumours of the testicle. These occur not only in 
male animals, but also in those which have undergone the operation 
of bistournage. 

It might a priori be believed that in an animal of the latter class 
the testicle had been completely destroyed, not only from the physical, 
but from the pathological point of view. This, however, is by no means 
the case, and Cruzel has described, under the erroneous designation 
of sarcocele, tumours of the testicle which develop in oxen of various 
ages. 

Moussu has had a similar experience with animals of from four 
to six years of age which had been carefully operated on. 

These tumours, the origin of which is unknown, develop at the 
expense of the rudiments of the atrophied testicle. They vary in 



TUMOURS OF THE TESTICLE. 



595 



character, and Monssu has onl}^ observed tumours of a type different 
from that of the testicle itself, containing tracts of carcinomatous, 
sarcomatous, and fibrous tissue. They also appear to vary greatly in 
gravity, for, although the cases seen by Moussu had become generalised 
in a few months, Cruzel states that these tumours may remain stationary 
for several years. 

The symptoms consist in progressive enlargement of the scrotal 
region and the appearance of 
a tumour surrounded by oede- 
matous or lardaceous tissue. 

The tumour, which is con- 
fined to one side, increases in 
size, is bosselated and adherent 
at points to the surface of the 
skin, while it is insensitive or 
only slightly painful to the 
touch. 

In a few months it may in- 
crease to the size of a child's 
head. The animals have diffi- 
culty in moving or lying down, 
the hind limb on the affected 
side is abducted, and the 
animal usually lies on its 
chest and abdomen. The 
patient rapidly loses flesh, 
although the appetite remains 
good. 

When the growth is re- 
moved, it is easy to prove 
that the tumour has developed 
in the atrophied mass of tes- 
ticular tissue, and that it re- 
mains suspended from the end 
of the cord. 

The diagnosis of tumour 
of the testicle is extremely easy, for the condition cannot be mistaken 
for a hsematoma or for a scrotal abscess. 

The prognosis necessarily depends on the nature of the tumour, 
but as it is impossible to determine this point before extirpation, the 
prognosis should always be regarded as very grave. 

Treatment. Whatever the nature of the tumour, ablation is ad- 
visable. If it is of a benign character, recovery may be complete and 

Q Q 2 




Fig. 239. — Upper surface of the neck of the 
bladder and origin of the urethra in the 
ox. 1, Bladder;- 2, vesiculse seminales ; 
3, vas deferens ; 4, principal portion of 
the prostate gland extending beneath the 
sphincter; 5, sphincter; 6, aponeurosis of 
the sphincter, clothing the upper portion 
of the urethra and the flattened portion of 
the prostate. (After Barrier.) 



596 



MALE GENITAL OEGANS. 



permanent, but if it is malignant, generalisation will rapidly ensue. 

Before interfering surgically, however, it is essential to examine the 

inguinal, pelvic, and sublumbar lymphatic glands, to make sure that 

they are not affected. If they prove 
to be already invaded, an operation 
should be avoided. 

Even despite such precautions and 
the apparent absence of any glandular 
infection, operation may be followed 
by generalisation in a few months, 
although for a short time the con- 
dition may seem to have greatly 
improved. No special indications 
need be given beyond those sug- 
gested as necessary in dealing with 
all kinds of tumours, whatever their 
nature. 

The skin should be freely divided, 
that the tumour may be thoroughly 
dissected out and no fragments be 
overlooked. The mass of the tumour 
having been dissected free, the ecra- 
seur is applied to the pedicle or the 
cord. Enucleation of the tumour 
may be very difficult on account of 
the presence of numerous ramifica- 
tions or attachments, but the closest 
attention must be given to removing 
every fragment if a fresh local growth 
is to be avoided. ' In the event of 
fragments being left, a fresh growth 
is certain to occur. 

Generalisation, which may extend 
to all the viscera (lymphatic glands, 
liver, spleen, lungs, pleura, peri- 
toneum, heart, etc.), is indicated by 
rapid wasting, fever, acceleration of 
breathing, digestive disturbance, and 
sometimes coughing, etc. 
Local new growths assume the form of ulcerating swellings. In 

practice, if the general condition can be improved for a short time, it 

is advisable to slaughter the animal. 




Fig. 240.— Roof of the neck of 
the bladder and first part of the 
urethra (mternal surface). 1, Ori- 
fice of the ureter ; 2, urethra at a 
pohit beyond the urethral valve ; 
3, submucous erectile tissue ; 4, 
urethral sphincter ; 5, vesiculee 
seminales ; 6, veru niontanum ; 7, 
orifices of the vesiculse seminales ; 
8, orifice of the vas deferens ; 9, 
orifices of the prostate ; 10, ureth- 
ral valve, showing on its free 
margin the point-like openings of 
the ducts of Cowper' s gland. (After 
Barrier.) 



ACCESSORY GLANDS OF THE GENITAL APPARATUS. 



597 



ACCESSORY GLANDS OF THE GENITAL APPARATUS* 

(prostate, vesicul^ SE:\riNALEs, cowper's glands.) 

Inflammatory or other diseases of the above 'glands are most Ire- 
qlient in entire animals. As a group they are uncommon, and are 
still ill-recognised and ill-described, being seldom identified except on 
post-mortem examination. 

The cause of inflammation of the prostate, of the vesicuhie semi- 
nales, and of Cowper's glands is probably an ascending infection of 
the urethra and neighbour- 
ing channels, a fact which 
explains the comparative 
rarity of such conditions in 
castrated animals. 

The pathogenic germs 
penetrate from the urethra 
into the excretory ducts of 
the glands, obtain a lodg- 
ment in the culs-de-sac of 
the glands themselves, and 
thus produce simple or sup- 
purative inflammation. 

The symptoms may 
easily be mistaken, to some 
extent at least, for those of 
acute cystitis or cystitis due 
to the presence of a cal- 
culus, and it is only by 
rectal examination that the 
diagnosis can be made. 

The first symptom is defective micturition, which occurs in jets, 
is intermittent and painful, and sometimes causes slight groaning. 
It is accompanied by vesical colic, spasmodic lifting of the hind legs, 
and more or less unsuccessful expulsive eftbrts. 

These symptoms are of reflex or mechanical origin, and are due 
either to direct compression of the urethra by an hypertrophied and 
inflamed gland, or to spasm of the vesical sphincter. The urine 
passed, unlike that in cases of acute cystitis or in cystitis due to 
calculus, is of a normal character. Eectal examination usually re- 
veals distention of the bladder, and hypertrophy and excej)tional sen- 
sitiveness at certain points. 
■ If the painful and hypertrophied area is over the neck of the 




Fig. 241. — View of Cowper's gland and of its com- 
pressing muscles. (After Cocu.) 1, Cowper's 
gland ; 2, compressing muscle ; 3, accelerator 
urinae muscle turned back to expose the gland ; 
4, sphincter of the urethra. 



598 Male genital ougans. 

bladder, this indicates that the lobes of the prostate are affected. 
If, however, the affected parts are situated on the sides of the neck 
and along the posterior pointed end of the bladder (Fig. 239), the 
vesiciilae seminales are affected ; finally, if the painful points are 
directly above the ischial arch and below the sphincter ani, Cowper's 
glands are the seat of disease (Fig. 240). 

To diagnose these conditions requires very close and careful exami- 
nation. They may easily be mistaken for acute cystitis, though the 
character of the urine should suggest doubts and lead to rectal exami- 
nation. 

Although they do not endanger the animal's life, these condi- 
tions give rise to such serious inconvenience as often to render entire 
animals useless for stud purposes. 

Local treatment is im]Dossible, and the practitioner is restricted to 
the use of anodynes, balsamic preparations and diuretics. The treat- 
ment, in fact, differs little from that of cystitis. In cases of suppu- 
ration of Cowper's glands, the abscess usually forms just below the 
anus and close to the median line. Thus the diagnosis may be con- 
firmed by capillary puncture, the part being laid open if necessary. 



SECTION VIII. 

DISEASES OF THE SKIN AND SUBCUTANEOUS 
CONNECTIVE TISSUE, 

CHAPTER I. J 

ECZEMA, 

Under the name of eczema may be grouped a series of cutaneous 
diseases characterised by pruritus, by a discharge from the skin, or 
simply by epidermic prohferation, without any apparent* parasitic or 
accidental cause. 

These diseases have been referred to a special constitutional con- 
dition termed a diathesis, although during the last few years we have 
come to recognise certain microbic and toxic influences in their pro- 
duction. In the ox eczema assumes different appearances. Accord- 
ingly, the disease has been divided into the acute, chronic, sebaceous, 
and toxic forms. 

ACUTE ECZEMA. 

Causation. In the ox, as in all other species, the determining 
cause is to be found in bad hygienic conditions, improper feeding, 
and in a special individual condition of the animal affected, that is 
to say, a diathesis. 

Symptoms. During a preliminary period, which might be termed 
a prodromic period, only general symptoms can be detected, such as 
fever, loss of appetite, digestive disturbance, constipation, etc. Local 
signs are still absent, or at least are not noticeable, and are only 
represented by congestion of the skin. 

The second phase is characterised by a papulous eruption which 
is difficult to detect, inasmuch as it occurs in the depths of the 
coat. Nevertheless, the skin is distinctly sensitive, and at numerous 
small points the hairs appear to stand upright. 

The third phase consists in the development of more or less con- 
fluent vesicles, with exudation and discharge. The disease is not 
really visible externally until after the hair has become agglutinated 



600 



ECZEMA. 



by the discharge. This discharge is seldom as abundant as in eczema 
in the dog or horse. It is produced slowly and dries rapidly. 

As the crusts fall, carrying with them a portion of the hair, the 
general symptoms disappear, but the sites of these vesicular patches 
now show cracks extending as deep as the dermis and often compli- 
cated by secondary infection involving suppuration, adenitis, abscess 
formation, or diffuse subcutaneous suppuration. 

Acute eczema is generally confined to the limbs. It may develop 
fully in from twenty-four to forty-eight hours. The acute stage is 
attained in a few days, and the condition disappears in two to three 
weeks provided it dofes not assume the chronic form as the result of 
complications. 

Diagnosis. The absence of parasites enables the condition to be 
distinguished from phthiriasis and acariasis, whilst the history pre- 
vents its being confounded with toxic eczema. 

Prognosis. The condition is troublesome rather than grave. Sup- 
puration is often persistent, and despite careful attention the discharge 
may only diminish slowly, while the disease is always liable to return. 
The treatment is local and general. Local treatment consists in 
emollient and antiseptic washes and the application of drying powders. 
The former comprise glycerole of starch, bran water, boric ointments, 
camphorated vaseline, iodine and glycerine. At a later stage the skin 
can be washed with decoction of oak bark or a weak iodine solution, 
followed by the application of talc or starch powder. As far as pos- 
sible this external treatment should be supplemented by the frequent 
use of mild purgatives and various diuretics, which seem to have 
a special action on the arthritic diathesis. 

CHRONIC ECZEMA. 

Comparatively few cases of chronic eczema have hitherto been de- 
scribed in oxen, and the details given are extremely meagre. Chronic 
eczema may assume that form from the first or may succeed acute 
eczem_a. 'The causes are probably the same in both conditions. 

The symptoms appear to be those of the acute form, but are much 
less severe. They consist in papulation, a mihary vesicular eruption, 
pruritus, and the formation of crusts and epidermic scales. 

In a case seen by Megnin the crusts separated and fell away, 
leaving bare spots. The disease re-appeared for several years in suc- 
cession. The spots finally remained bare, but showed no thicken- 
ing of the skin and no microscopic changes. 

^ Diagnosis. Microscopical examination is necessary to distinguish 
this disease from scabies or ringworm. 



SEBACEOUS OR SEBORRHO'JC ECZEMA. 



601 



The prognosis is grave, because large areas of the skin may be 
invaded in succession. 

Treatment. As in acute eczema, the condition is improved by 
the ]3rolonged administration of small doses of salines and diuretics. 
Arsenical preparations are also valuable, but should only be employed 
for two or three weeks together, with intervals of equal duration. 
The dangerous complications which sometimes result from accumula- 
tions of this drug in the system are thus avoided. 

SEBACEOUS OR SEBORRHCEIC ECZEMA, 

Whilst the two preceding forms of eczema result from vascular 
disturbance of the skin or dermis that now under consideration seems 




Fig. 242. — Sebaceous eczema, first stage. Depilation of the extremities. . 

due to vascular and secretory troubles in the accessory structures of 
the skin, and more particularly in the sebaceous glands. 

Symptoms. The disease develops slowly. At first circular or 
elliptical patches of skin, distributed regularly over the body, more 
especially round the natural orifices, become deprived of hair. The 
surface of these patches is covered either with thick crusts of a pecu- 
liar greyish-brown tint which display numerous superficial cracks, or 
parts normally free from hair exhibit shining epidermic crusts ar- 
ranged in layers, which are shed on the slightest touch. 

This depilation has a strong tendency to spread, and so at first 
it often resembles ringworm. It results from changes in the hair 



602 



Eczema. 



follicles, with atrophy of the papillae and complete loss of haii'. 
The changes in the skin, however, are little marked. The skin 




Fig. 243. — Sebaceous eczema, second stage. Partial alopecia. 

itself is but slightly thickened and preserves its usual suppleness, 
while the subcutaneous tissue is not oedematous. 




Fig. 244. — Sebaceous eczema, third stage. Total alopecia. 

The hairs, however, when examined microscopically are found to 
be thickened at their roots, though otherwise throughout their whole 



ECZEMA DUE TO FEEt)ING WITH POTATO PULP. 603 

length they remam normaL The condition is a consequence of dis- 
turbance in the circulation and nutrition of the papilla and the root 
of the hair. 

Finally, the congestive process extends to the sebaceous glands, 
the secretion of which it modifies, and sets up seborrhoea, which is 
responsible for the formation of the crusts and epidermic scales 
above-mentioned. 

The pathogeny of the disease is difficult to explain, but the stages 
in the clinical development are as follows : the skin undergoes re- 
peated attacks of congestion, followed by seborrhoeic folliculitis, epider- 
mitis and loss of hair. 

The diagnosis is easy, the absence of ringworm being proved by 
the absence of the spores of trichophyton and by the non-contagious 
character of the discharge. 

The prognosis is not grave from the point of view of general 
health, the chief functions being perfectly regular, but it is otherwise 
as regards possible terminations, viz., partial or total loss of the coat, 
which may be irremediable. 

Treatment. It is difficult to lay down a really satisfactory method 
of treatment, because the exact cause of seborrhoea is still unknown. 
As it is probably to be sought in some individual constitutional 
peculiarity, the feeding and method of life should be changed and 
the skin stimulated by washing with lukewarm water and soap and 
by dry friction. Locally, if the alopecia threatens to be permanent 
stimulating applications may be tried. These comprise lotions con- 
taining alcohol, solutions of chloral, salicylate of soda, etc., and they 
should be applied with smart friction. 

The sufferers should not be used for breeding purposes. 

ECZEMA DUE TO FEEDING WITH POTATO PULP. 

Among the forms of eczema due to toxins, several varieties may 
be recognised. Some result from the administration of drugs such 
as iodine, others from special forms of food. The only one of clinical 
importance is that following the consumption of excessive quantities 
of potato pulp. 

Causation. The disease is seen in all districts in which potatoes are 
employed for the manufacture of alcohol and starch, more especially 
in Germany. The disease seems to be a direct consequence of feeding 
with residual products of distilleries and starch manufactories. 

Spinola states that 160 lbs. of potato refuse per day to 1,000 lbs. 
of body weight would certainly produce eczema : 60 to 80 lbs. only 
produce it in rare cases and 20 to 40 lbs. are harmless. 



604 ECZEMA. 

There is a further pomt to consider as regards the variation of 
potato pulp in toxicity. Potatoes yield a more or less active residue, 
according to the year in which they are grown, their state of germi- 
nation, and the variety to which they belong. Eaw or cooked potatoes 
may produce eczema if given in large quantities or for long periods. 

Numerous theories have been advanced as to the nature of the 
morbid disturbance producing eczema. Some authorities declare the 
appearance of the disease to be due to the presence of a toxic principle 
contained in potatoes, viz., solanin. It, might be objected that this 
chemical principle only exists during germination while potatoes that 
have not undergone germination produce the disease. Further, the 
symptoms of poisoning by solanin difi'er from those of this form of 
eczema, among which loss of appetite, for instance, or stupefaction, or 
narcosis is never observable. 

According to other writers eczema is due to the action of the 
lower alcohols contained in the refuse pulp, but again these pro- 
perties exist in brewers' and distillers' grains, the consumption of 
which produces no bad results. Similar objections might be made 
regarding the suggested action of the acids of fermentation (lactic, 
butyric, and acetic acids, etc.). 

Johne blames the salts of potassium, which, however, can only act 
as digestive irritants, and Ziirn suggests mycosic inflammation. 

Whatever the toxic principle, its effects are most marked in 
animals undergoing fattening, and are rarely found in working oxen, 
still more rarely in milch cows. In the last named the injurious 
principle appears to be eliminated in the milk, and this theory is 
supported by the fact that the liquid has purgative properties ; the 
calves which consume it suffer from diarrhoea, which ceases when the 
feeding is altered. 

Finally, it has been proved that different animals show different 
degrees of susceptibility to the action of potato piulp. 

The symptoms do not appear until after two or three weeks' feed- 
ing on the potato pulp. Then the animals walk stiffly, rise with 
difficulty, and display redness, swelling and sensitiveness of the limbs. 
When the oedematous infiltration and reddening have become dis- 
tinctly marked there apjDear, not only between the claws, as in foot- 
and-mouth disease, but over the entire limb and principally near the 
folds of skin about the joints, numerous closely-packed small papules, 
which in one or two days become transformed into vesicles through 
exudation below the epidermis. 

This marks the eczematous phase properly so called. The vesicles 
then become ruptured, the exuded matter glues the hairs together, 
dries, and forms crusts, which have a peculiar and distinctive odour. 



IMPETIGO IN THE PIG. 605 

The disease may extend towards the hocks, the knees, the stifle, 
the armpit, etc. In the folds of skin sm^rounding the joints deep 
cracks form, and sometimes become secondarily infected, thus leading 
to the development of lymphangitis. 

General symptoms, such as fever, loss of appetite and constipa- 
tion, always follow ; they are afterwards succeeded by diarrhoea and 
progressive weakness, ending in death. 

The disease is easily curable if seen in its earlier stages, but after 
all signs of the first attack have disappeared, the condition may return 
five or six times in a year if potato pulp is again given. Kecovery 
is always very difficult in aged or enfeebled patients. 

The mortality varies greatly; formerly it was as high as 20 per 
cent., but at the present time it is much lower. 

Diagnosis. Provided the history of the case is borne in mind, the 
diagnosis is always easy. 

The prognosis is not grave if the disease is treated early. 

Treatment. This consists first of all in altering the diet and 
reducing the quantity of potato pulp, or, better still, in discontinuing 
it entirely. The food should consist of good hay, bran, oatmeal gruel, 
pollard, etc. Internally, diuretics are given to assist in the elimination 
of the toxic products. 

This treatment arrests the course of the disease. Suitable local 
treatment will remove the existing lesions. It is precisely similar in 
character to that of acute eczema, but it must be borne in mind that 
it can only prove effective if the primary cause be removed. 

IMPETIGO IN THE PIG, 

The term impetigo is used to describe a disease characterised by 
an eruption of papules, the discharge from which forms yellowish 
crusts, which when dry are of a grey or brown colour. The point of 
origin of the eruption is unknown, but the crusts rapidly become 
infected on contact with the air, and the bodily lesions may end in 
suppuration. The disease is not frequent nowadays except in sucking 
pigs and in large or badly-kept piggeries. 

Symptoms. The eruption usually appears between the ages of 
two and three months, and is accompanied from the first by moderate 
pruritus. The papules rupture after two or three days and discharge 
a lemon-coloured liquid, which is distributed over the surface, dries 
rapidly, and causes the bristles to stick together at the roots. The 
crusts formed in this way remain adherent to the skin, though their 
surface becomes cracked. They increase in thickness, cover the head 
and part of the body, particularly the belly and the inner surface of 



606 ECZ*EMA. 

the thighs, and if removed, an operation of some difficulty, leave ex- 
posed a bleeding, sanious, or purulent wound. The animals lose 
condition and appetite, cease to grow, seem as though attacked with 
rachitis, and may die if the general conditions of their maintenance 
are not improved. 

The diagnosis is not difficult, but the prognosis depends on how 
long the disease has existed and the bodily condition of the patients. 

The treatment consists entirely in improving the hygienic condi- 
tions and the feeding. The patients must be repeatedly washed or 
bathed and carefully disinfected, and they must have better food. 

The crusts should be softened before the animals are washed, so 
that bleeding may be avoided and the affected areas not be trans- 
formed into suppurating wounds. By applying oil or some fatty 
matter to the crusts it is possible to cleanse the parts with bran 
water. If considered necessary, this cleansing can be followed by 
dressing with boric or weak creolin solution. Open-air life and good 
food soon relieve the principal symptoms. 

ACNE IN SHEEP. 

Acne, that is to say, localised inflammation of the sebaceous glands 
and hair follicles, sometimes occurs in sheep apart from any parasitic 
invasion. The eruption is particularly seen after shearing, and it is 
probable that, as in the horse, irritation produced by the machine, 
and possibly by accidental infection, constitute the principal determining 
causes. 

Symptoms. The disease is indicated by the appearance of cuta- 
neous pustules, which are only slightly painful on pressure and which 
involve the entire thickness of the skin. The dermis is hardly 
congested, and no constitutional disturbance occurs. 

Acne lesions may be more or less confluent, and may attain the 
size of a small hazel-nut. 

The diagnosis presents no difficulty. Puncture or incision reveals 
the fact that the abscesses are filled with white sebaceous material and 
are quite free from parasites. 

The prognosis is not grave. Recovery occurs spontaneously in a 
few weeks. 

Treatment. Liquid emollient applications and the opening of the 
small follicular abscesses appear to represent the only means of 
hastening recovery. 

FAGOPYRISM (BUCKWHEAT POISONING). 

Fagopyrism is a disease of toxic origin in sheep, and is due to 
eating buckwheat (Polygonum fagopyrum). 



FAGOPYRISM (BUCKWHEAT POISONING). 607 

The disease has also been entitled erysipelatous or gangrenous 
dermatitis, according to its form and gravity. 

Causation. The cause is extremely simple, viz., the consumption 
of buckwheat and other food pertaining to a like species, such as 
Polygonvm persicaria. The green plant and the straw give the same 
results, but the action of light and air are also necessary for the 
production of the disease, a fact which is somewhat difficult to explain. 

According to German writers the disease occurs more frequently in 
white sheep and lambs than in those in which the skin is of a very 
dark colour. 

Symptoms. When the sheep are fed in folds, with the green plant in 
summer or with the straw in winter, nothing unusual is seen, the herds 
being, to all appearance, in perfect health. On their being set at liberty, 
however, the first symptoms appear, perhaps in less than an hour. 
Some animals become restless, make peculiar movements of the head, 
and soon display intense congestion of the parts free of wool, together 
with redness and swelling of the ears, eyelids, face, throat, etc. The 
condition develops with extreme rapidity, the animals being immediately 
afflicted with pruritus over the affected regions. If they are not re- 
moved to the quiet and warmth of the fold the symptoms increase 
and papules appear, which may be transformed into vesicles and bullae. 
In the fold, on the other hand, all the symptoms rapidly disappear. 

The disease rarely assumes an erysipelatous form, but respiratory and 
cerebral symptoms, together with fever and vertigo, are not exceptional. 

Treatment. The feeding on buckwheat should at once be discon- 
tinued, and the patients should be kept in the fold until the toxic 
principles have been eliminated, that is, for a month or more. 

Bicarbonate of soda may be added to the drinking water. The 
local lesions about the head must be kept clean and dressed with anti- 
septic astringent lotions. 



CHAPTERII. 
PHTHIRIASIS, 

The term phthiriasis is applied to infestation of the skin with lice. 

Causation. These diseases are due to the presence of various para- 
sites which live by destroying the epidermic scales, or by piercing the 
superficial layers of the skin. They are of a greyish-yellow colour, and 
belong to the genersi HcBmatopinus and Trichodectes. 

The Hcematojnnus forms have pointed heads, and are equipped for 



^'"^ 




Fig. 245. — Hcematopinus eurysternus of 
the ox, magnified 20 diameters. (After 
Neumann.) 




Fig. 246. — Hce7natopinus of the calf, 
magnified 20 diameters. (After 
Nemnann.) 



penetrating the skin by suction. The Trichodectes have a large flat 
head constructed for masticating. 

The ox harbours two forms of Hce^natopinus and one of Trichodectes, 
the HcEinatopinus eurysternus and temdrostrus , and the Trichodectes 
scalaris. 

The sheep suffers from Trichodectes spherocephakis and a Melophagiis, 



PHTHIRIASIS. 



609 



the goat from the Hcematopinus stenops and the Trichodectes climax, and 
the pig from the Hcematopinus uritts. 

The symptoms are, with trifling variations, the same in all domestic 
animals, the principal being rubbing and itching. The animals scratch, 
bite and attempt to rub against hard objects, even abrading the skin 
when this is thin and the irritation is severe. 

The parasites may, howevei% remain localised, and it rarely happens 




Fig. 247. — Sheep louse {Tricliocephalus splutrocephalus). a, Female; 6, antenna ; 
c, d, dorsal and side view of leg. Enlarged. (After Osborn, 1896 ; Bui. No. 5, 
Div. Entomology, Dept. Agr.) 



that they are present in any considerable number in all parts of the 
body. 

In the ox they are principally found in the depression at the back 
of the base of the horns, and in the upper margin of the neck and the 
back. In the absence of treatment phthiriasis may become generalised 
over the entire surface of the body. 

The trichodectes and the melophagus of the sheep choose similar 
points, but when the wool is long they may be found nearly all over 
the body. 

In the pig the haematopinus is found on the neck, in the region of 
the poll, about the armpits, and round the eyes and easr. 

D.c. R R 



610 



PHTHIRIASIS. 



These parasites, whose powers of increase are astonishing, keep the 
patients in a continual state of irritation, causing them to lose con- 
dition and, in the absence of treatment, to die of exhaustion. 

The diagnosis is very easy, the parasites being visible to the naked eye. 

The prognosis is not grave unless the condition affects a large 
number of animals in herds. In young animals the prognosis is much 
graver, for the little creatures rapidly become anaemic and die in a 
state of exhaustion. 

Treatment. When the byre, fold, or piggery is infested the first point 
is to remove the animals and thoroughly disinfect and cleanse all parts. 




/f"^--!^tM^7rr'^\ 





Fig. 248. — Sheep foot louse {Hcemato^jinus pedalis). a, Adult female ; b, ventral 
view of terminal segment of same, showing brushes ; c, terminal segments of male ; 
d, egg. Enlarged. (After Osborn, 1896; Bui. No. 5, Div. Entomology, Dept. Agr.) 



After the manure has been cleared out, the walls, mangers, racks, 
etc., are washed with boiling water, or, better still, potash solution, and 
disinfected first with vaporised sulphurous acid, then, if necessary, with 
a w^ashing of caustic lime. 

The patients are afterwards clipped, washed with soft soap and 
dressed with anti-parasitic solutions, such as 1 per cent, tobacco juice, 
or a mixture of equal parts of benzine and oil or benzine and petroleum, 
etc., which give excellent results. 

A 3 per cent, creolin solution is also a very active anti-parasitic and 
very easy to use. 



SCABIES IN SHEEP. 



611 



All these solutions, however, are more or less poisonous and need 
to be used with caution, weak solutions only being used at first, par- 





FiG. 249. — Adult sheep tick {Meloijhagus 
ovinus). {a) Tick ; (6) puparium. Magni- 
fied. (Salmon and Stiles, Annual Report, 
U.S.A. Dept. of Agriculture, 1897, p. 103.) 



riG.250.— TWc7io- 

dectes scalaris 
of the ox. Mag- 
nified 20 dia- 
meters. (After 
Railliet.) 



ticularly in the case of animals, such as oxen, which are given to licking 
themselves. 

SCABIES— SCAB— MANGE, 

The term scabies is given to a group of diseases affecting man and 
all domestic animals. These diseases are produced by two classes of 
parasites, viz., sarcoptinge, which live within the epidermis or on the 
surface of the skin, and demodectes {sing, demodex), which penetrate 
into the sebaceous glands and hair follicles. 

Scabies, though know^n from the earliest times, has long been con- 
founded with constitutional diseases characterised by cutaneous erup- 
tions. The symptoms shown were formerly regarded as due to the 
elimination of " humours " which the organism was casting off, for 
which reason scabies was even treated with internal medicines. 

At the present time the cause of the disease is perfectly well under- 
stood, as well as the mode of development of the different parasites. 
The rate at which these parasites develop is almost incredible, a fact 
which explains the highly contagious character of the disease. 

■ Each species of animal may present several varieties of scabies, 
caused by different parasites, such as sarcoptes, psoroptes, chorioptes, 
demodectes, etc. 

SCABIES IN SHEEP. 

Scabies in sheep usually assumes one of three forms — sarcoptic, 
psoroptic, or chorioptic scabies. Follicular, or demodectic, mange affects 

R K 2 



612 



SCABIES — SCAB — MANGE. 



the eyelids, and is very rare. It is produced by the Demodex follicu- 
lorum var. ovis. 



SAKCOPTIC SCABIES. 

This scabies has long been recognised as affecting more especially 
the head, muzzle, etc. It was mentioned as long ago as the fom'teenth 
century by Jehan de Brie, but, until Delafond's time, no one recognised 
that it was caused by an acarus. In 1858 Delafond discovered the 
parasite in Piedmont sheep. 

Causation. Formerly, writers on the subject and shepherds attri- 
buted this disease to the wounds and excoriations which sheep receive 
in passing through brambles, holly, etc., or in rubbing against their 

racks. The true cause of the disease 
is the presence under the skin of the 
Sarcoptes scahei var. ovis, which passes 
from sheep to sheep by direct con- 
tact. The animals attempt to rub 
against everything about them, even 
against their neighbours. These para- 
sites can be transferred from the goat 
to the sheep, and rice versa. 

Walraff, Eoloff, Delafond, Gerlach 
and Eailliet have described cases of in- 
fection in man, but the disease is rarely 
more than of a tem23orary character. 

Symptoms. This form of scabies 
affects the head and the parts free 
from wool. 

At first the parasites invade the 
upper lip and the tissues about the 
nostrils, sometimes, but more rarely, 
the eyes and ears. They cause the 
formation of vesicular papules, ac- 
companied by violent itching. The 
animal, in rubbing itself, excoriates these papules, which discharge a 
fluid and soon become covered with yellowish-brown crusts. 

The disease afterwards invades the face, forehead, jaws, and entire 
head. The skin becomes wrinkled and the brownish crusts thicker 
and more abundant. These are fissured and bleeding, and they give 
the face the appearance of one vast sore. 

The parasite rarely attacks the region of the elbow, the belly, or 
the inside of the thigh. The disease never advances in parts covered 
by wool, although in breeds of sheep with thick wool, such as are found 




Fig. 251. — Sarco]3tis, magnified 100 
diameters. (After Eailliet.) 



SARCOPTIC SCABIES. 



613 



in Algeria and Tunis, the sarcoptic form of scabies may become 
generalised and attack the entire bod}^ The extremities of the limbs, 
however, are usually attacked after all the head has become involved. 

Throughout the course of the disease the patients scratch and rub 
themselves, thus tearing off the crusts and causing bleeding and the 
formation of new crusts of a blackish hue. This form of scabies 
about the head may become complicated with conjunctivitis, the 
inflammation extending from the extremity of the eyelids to the con- 
junctiva. This arises from the fact that the membrane is frequently 
injured by the animal rubbing the parts. Conjunctivitis may be so 
intense as to lead to purulent ophthalmia and the loss of the eye. 

Diagnosis. Sar- 
coptic mange in 
sheep cannot be 
mistaken for any 
other disease on 
account of its lo- 
calisation. 

Prognosis. The 
disease is not very 
dangerous, for it 
is easy to treat, 
though if left to 
itself it might in 
time become fatal. 

Treatment. 
Preventive treat- 
ment consists in 
isolating diseased 

animals, cleansing and disinfecting the folds, and preventing the in- 
troduction of diseased animals into healthy flocks. 

Curative treatment. When the disease is detected at an early 
stage anti-psoroptic remedies may be directly employed. 

If, however, it is of old standing, the crusts must first be softened 
and removed by the use of fatty substances, such as vaseline or oil, 
before any curative treatment can be undertaken. 

The crusts can be removed in from twenty-four to forty-eight 
hours by vigorous washing wdth soft soap and the application of anti- 
parasitic solutions. The omission to wash the parts causes drugs to 
lose much of their efficacy. 

Helmerich's ointment, oil of cade, mixtures of oil, benzine and 
petroleum, and 3 per cent, to 4 per cent, of tobacco juice, are the 
commonest and most efficacious applications. 




Fig. 252. 



-Sarcoptic mange of the sheep, showing the 
appearance of the head. 



614 SCABIES — SCAB— MANGE. 

A non-poisonous ointment may be made by taking 4 ounces of oil of 
turpentine, 6 ounces of flowers of sulphur, and 1 lb. of lard. Mix the 
ingredients at a gentle heat, and rub in well with the hands or with a 
brush, at the same time breaking the crusts. The simple sulphur oint- 
ment may be made of one part of sulphur and four parts of lard ; one 
fourth part of mercurial ointment may be added. Few remedies are so 
useful as sulphur iodide, and it may well be given a trial on head scab. 

In most countries this disease has been made the subject of special 
legislation. 

PSOROPTIC MANGE SHEEP SCAB. 

This is probably the gravest form of mange. It was described by 
Cato the Censor in 160 e.g., by Virgil, Juvenal, Celsius, Columella, 
Pliny, Vegetius, etc. In 1787 Abildgaard first showed that psoroptic 
mange in sheep could be cured by simple external remedies, without 
internal medications. In 1809 Walz described the causes, nature, 
seat, and treatment of the disease. 

Since then, the parasitic, contagious nature of mange or scabies 
has been more and more clearly recognised. 

Causation. Experience and observation have long shown that the 
only cause is the j^i^esence of the Psoroptes communis (ovis). This 
disease is much more contagious than that just described. Psoroptic 
mange or scabies exclusively affects those portions of the body covered 
by the wool, and may for a long time remain unrecognised. 

The parasite is visible to the naked eye, though most inspectors 
employ the microscope. The adult female is about 4^0 of an inch long 
and 6^Q of an inch broad ; the male is -^^ of an inch long and -^q of an 
inch broad. The mites are discovered more easily on a dark back- 
ground, and if a portion of the wool and crusts is placed on black 
paper and exposed to the sun for a few minutes the parasites will 
generally be seen crawling about on the paper. 

The disease is transmitted directly or indirectly by contact from 
diseased to healthy animals in the folds, fields, or sheep runs. One dis- 
eased sheep may contaminate an entire flock. The disease is extremely 
contagious, and may appear even within a week after exposure. 

The parasites have exceptional vitality. It is generally stated that, 
kept at a moderate temperature on portions of scab, the adults may 
live from four to twenty days, but they will occasionally live much 
longer ; cases are on record where they have lived three, four, or 
even six weeks when separated from sheep ; if the atmosphere is dry 
they will generally die in about fifteen days ; but death is often only 
apparent, for the mites may sometimes be revived by warmth and 
moisture even after six or eight weeks ; the fecundated females are 
especially tenacious of life. 



PSOROPTIC MAiNGE — SHEEP SCAB. 



615 



Experience has shown that m some cases apparently healthy sheej) 
have become mfected in places where no sheep have been kept for four, 
eight, twelve, or even twenty-four months. The conditions underlying 




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this infection are not thoroughly understood. Possibly some of the 
eggs have retained their vitality a long time and then hatched out ; 
possibly the vitality of the fecundated female has also played a role ; 



616 SCABIES — SCAB — MANGE. 

while it is not at all improbable that an entirely new infection has 
accidentally been introduced by birds or other animals. Certain 
authors of high standing scout the idea that birds can introduce an 
infection of scab, but there is no reason why birds should not do this, 
and there are some reasons for believing that they do. It has been 
noticed on the Experiment Station of the United States Bureau of Agri- 
culture, for instance, that crows delight in perching on the backs of 
scabby sheep and picking at the scab ; while so doing it is only natural 
that small tags of wool wOuld adhere to their feet, and thus scatter scab. 

Delafond's experiments show that psoroptic mange is most trouble- 
some amongst thin, ill-nourished, weakly animals, whilst robust sheep 
in good condition may be cured simj)ly by attention to cleanliness and 
abundant feeding. 

In America this disease causes extremely heavy pecuniary loss 
second only in importance to that produced by hog cholera. It has 
also interfered very seriously with the export of American sheep. 

The course of the disease is affected by the time of year and sur- 
rounding conditions. In autumn and winter, when sheep are in con- 
tinual contact in a moist, warm atmosphere within the folds, the 
disease makes rapid progress. Young, weak, closely-inbred animals, 
and those with long, coarse wool, most quickly succumb. Unhealthy 
surroundings, damp, and bad ventilation favour the disease. Pure or 
mixed bred merino sheep suffer severely. In summer the animals are 
generally shorn and live in the open, and the disease then usually 
diminishes or may even be arrested. 

A study of the life history of the scab parasite is necessary in 
order to determine several important points of practical value, such 
as the proper time for the second dipping, etc. 

The female mite lays about fifteen to twenty-four eggs on the 
skin, or fastened to the wool near the skin ; a six-legged larva is 
hatched ; these larvae cast their skin and become mature ; the mites 
pair and the females lay their eggs, after which they die. The exact 
number of days required for each stage varies somewhat, according to 
the writings of different authors, a fact which is probably to be ex- 
plained by individual variation, and by the conditions under which 
the observations and experiments were made. Thus Gerlach, in his 
well-known work (1857) estimates about fourteen to fifteen days as 
the period required for a generation of mites from the time of pair- 
ing to the maturity of the next generation. He divides this time as 
follows : Under ordinary conditions the eggs hatch in three to four 
days, although two authors allow ten to eleven days for the egg 
stage ; three or four days after birth the six-legged larvae moult and 
the fourth pair of legs appears ; this fourth pair is always present 



PSOROPTIC MANGE — SHEEP SCAB. 



617 



when the mites are two-thh'ds the size of the adults ; when seven to 
eight days old the mites are mature and ready to pair ; several (three 





O »3 



PR 



or four) days are allowed for pairing ; another generation of eggs 
may be laid fourteen to fifteen days after the laying of the first gene- 
ration of eggs. Without going into all of the other observations on 



^18 SCABIES — SCAB— MANGE. 

these points, it may be remarked that the eggs may not hatch for 
six or seven days; the six-legged larvae may moult when three to 
four days old, and become mature; after pairing, a second moult 
takes place, lasting four to five days; a third moult follows imme- 
diately, then eggs are laid and the adults die; in some cases there 
is a fourth moult, but apparently without any further production of 
eggs. Accepting Gerlach's estimate of fifteen days as an average for 
each generation of ten females and five males, in three months'" time 
the sixth generation would appear and consist of about 1,000,000 
females and 500,000 males. 

Several practical lessons are to be drawn from these figures : Firstly, 
it is seen that the parasites increase very rapidly, so that if scab is 
discovered in a flock, the diseased sheep should immediately be iso- 
lated; secondly, if new sheep are placed in a flock, they should either 
first be dipped, as a precautionary measure, or they should at least 
be kept separate for several weeks to see whether scab develops ; 
thirdly, since the chances for infection are very great, the entire flock 
should be treated, even in case scab is found only in one or two 
animals ; fourthly, as dipping is not certain to kill the eggs, the sheep 
should be dipped a second time, the time being selected between the 
moment of the hatching of eggs and the moment the next generation 
of eggs is laid. As eggs may hatch between three and seven, possibly 
ten^ or eleven days, and as fourteen to fifteen days are required for the 
entire cycle, the second dipping should take place after the seventh 
day, but before the fourteenth day; allowing for individual variation 
and variation of conditions, the tenth, eleventh, or twelfth day will be 
the best time to repeat the dipping. 

Symptoms. Psoroptic mange attacks the parts covered with wool, 
so that attention is only drawn to the disease by some slight injury 
to the fleece, which becomes rough, matted, brittle, and liable to fall. 

Scabies commences with intense pruritus. The animals scratch and 
bite themselves, and tear away the fleece. These symptoms become 
aggravated when the animals are hot, as, for instance, when travelling. 
If the sheep have travelled through mud, the fleece becomes matted 
on the neck, behind the shoulders, and at all points where they are 
able to scratch themselves with the hind limbs. 

When a scabby sheep is touched at a diseased point, the animal 
shows pleasure by nibbling and moving the head up and down. 

At an early stage, if the fleece is divided and the skin examined, 
little papules may be discovered somewhat less in size than a lentil'. 
They are of a yellowish colour, and are distinctly visible against the 
reddish colour of the skin. These papules are due to tlie attacks of 
the psoroptes. 



PSOROPTIC MANGE — SHEEP SCAB. 



619 






Fig. 255. — Left top figure, egg of mite which causes common sheep scab; middle top 
figure, six-legged stage of sheep scab mite ; right top figure, young female before 
moulting for the last time, dorsal view ; middle figure, adult male parasite of 
sarcoptic scabies of man (the corresponding parasite of sheep is xevj similar), 
ventral view, X 250 (after Blanchard) ; left bottom figure, adult female parasite 
of sarcoptic scabies, dorsal view, X 250 (after Blanchard) ; right bottom figure, 
same, ventral view (after Blanchard). All greatly enlarged. 



^^^ SCABIES— SCAB— MANGE. 



They 80011 become more numerous and even confluent, break and 
discharge, become converted into pustules, and cause the formation 
ot crusts. In a few days the diseased points are covered with a 
squamous, ye lowish, sticky covering, under which the psoroptes lie 
hidden and which affords them nourishment. 

The crusts steadily grow thicker and lift the individual fibres of 
wool, tearmg them from their follicles, so that patches of skin become 
bare. The patches thus formed increase in diameter, for the acari 
leave the centre, where crust-formation is replaced by abundant de- 
squamation of the epidermis. The sldn is thickened, assumes the 
character of parchment, and in old-standing cases becomes wrinkled. 

ihe disease always commences along the back, withers, loins, and 
the upper part of the quarters. Thence it spreads to the flanks and 
sides of the chest. The psoroptes are almost exclusively confined to 
recently aflected points on the edges of the scabby patches. They 
are visible to the naked eye, and appear as little whitish-brown 
points. 

Scab is specially liable to attack a flock containing lambs and 
yearling sheep, whose skin is thin, fine and supple, and therefore 
inore susceptible to their attacks. If a portion of a scabby flock be 
shorn, the shorn animals will probably recover on account of the 
psoroptes transferring themselves to the animals with long fleeces. 

The diagnosis is easy. Psoroptic mange cannot be mistaken for 
sarcoptic mange, on account of the different points affected. 

Psoroptic mange only attacks regions covered by wool, and sarcoptic 
mange those free of wool. A microscopical examination of acari re- 
moved from the diseased animals will, however, immediately remove 
all doubt. 

Nor can the disease be confounded with phthiriasis, the tricho- 
dectes being immediately distinguished from the psoroptes by their 
greater size and the shape of their head. Moreover, they are usually 
to be found on the front portions of the shoulders. 

It is more likely to be mistaken for another disease, termed by 
some writers seborrhoea' and studied and described by Delafond under 
the name of sebaceous folliculitis. This disease appears mostly in 
autumn, and attacks animals much exposed to the weather and on 
moist, cold soils. It begins with very violent pruritus, followed by 
bitmg and loss of portions of the fleece. The skin is red, inflamed 
and painful, and the wounds are covered with large quantities of 
yellowish acid discharge of a sticky and offensive nature. The treat- 
ment of this disease consists in placing the sheep in clean, dry, well- 
ventilated sheds. Eecovery is assisted by clipping and the application 
ot some emollient dressing to the diseased parts. 



PSOROPTIC MANGE — SHEEP SCAB. 621 

The ease with which the disease can be cured and the absence of para- 
sites enable one to readily distinguish it from psor optic mange (scab). 

Prognosis. The disease is not specially grave, so long as only a few 
animals are affected, for it is not difficult to cure by isolation, good 
feeding, and proper external treatment ; but if scab appears in a flock, 
the freedom with which the animals intermingle is such that all are 
rapidly attacked, and the irritation produced at once checks their growth 
and causes loss in condition. Many ewes give birth to small, feeble 
lambs, which are almost certain to die, and in any case the wool is 
considerably diminished in value. 

Delafond estimated that psoroptic mange formerly attacked one 
thirty-fifth of all the sheep in France every year, causing damage to 
the extent of five francs per head. At the present time, and since 
proper sanitary laws have been instituted, it has become much less 
common. 

During the bad season of the year the mortality is greater, and 
may reach as much as from 40 to 50 per cent. In cases where 
scab is accompanied by some other disease, such as distomatosis, it 
may even rise to 80 per cent. 

The treatment is preventive and curative. PreYentive treatment 
consists in separating the healthy from the diseased animals and in 
disinfecting the folds, sheds, etc. 

Curative treatment. The first point in this treatment consists in 
improving the diseased animal's food both as to quality and quantity. 

It is to be observed that the parasite has more difficulty in living 
on robust and well-nourished animals. Moreover, observation shows 
that transference from poor land to rich pastures is sometimes in 
itself sufficient to bring about a spontaneous cure. Such, at least, 
is the belief of the Spanish sheep farmers in Estramadura and of the 
French shepherds. 

The shepherd can do a great deal to arrest the course of the disease. 
If he is careful, zealous, intelligent and observant he will quickly note 
the first indications of the disease and, by isolating the animals, check 
its spread. 

The second point consists in shearing the diseased animals, and 
this must be carried out at any season of the year. The money loss 
is sometimes important, but must be met, for otherwise treatment is 
impossible. In cases of localised scab, empyreumatic oil, oil of cade, 
solutions of sulphuret of potassium, decoctions of black hellebore (water 
1 quart, fresh rhizome 4 ounces or dry rhizome 2 ounces), de- 
coction of tobacco and diluted tobacco juice (6 ounces in 1 quart 
of water) have been recommended. Such local treatment, however, 
is often useless, because incomplete. 



622 SCABIES — SCAB — MANGE. 

When scab is generalised and it is impossible to define the parts 
attacked, general treatment is indispensable and the diseased sheep 
should be dipped. 

As a preliminary, however, and in order to make sure that the 
application will produce its effect, the animals after shearing should 
be passed, twenty-four hours before the medichial bath, through a warm 
bath containing soap in order to soften and remove the scabs. Appli- 
cations of oil or some fatty substance will also soften the scabs, which 
may afterwards be removed with a scraper without producing bleeding. 
One pound of soft soap may be dissolved in fifty quarts of water and 
each sheep plunged into this and scrubbed with a brush for a few 
minutes. Washing alone removes a large number of the parasites. 

Whatever bath be used it should not be given until four or five 
hours after the last feeding. The dips most popular in France are 
as follows : — 

Tessier's Bath (1810). 

/ Arsenious acid . . . . . . Ih parts or lbs. 

For 100 sheep . . . . \ Sulphate of iron , . . . 10 ,, 

i Water . . 100 

The above materials should be boiled for ten minutes, and, as a 
consequence of the chemical fusion which occurs in the process, the 
proportion of arsenious acid dissolved amounts to about 2 drachms 
per quart instead of 3f drachms. 

In this bath the arsenious acid acts as a parasiticide and the 
sulphate of iron as an astringent, the latter checking the absorption 
of toxic principles by the skin and sores, and preventing the sheep 
from licking themselves. 

Absorption by the skin is not so dangerous as has been believed. 
Eossignol has shown that poisoning need not be feared in chemical 
baths unless the proportion of dissolved arsenic is above 150 grains 
per quart, especially if the period of immersion does not exceed five 
minutes. Even pure solutions of arsenic, free from any astringent, 
may be used, provided the quantity in the bath does not exceed 
120 grains per quart. 

The bath should, if possible, be kept warm — 85° to 95° Fahr. 
(30° to 35° C). 

Four men are generally employed for the operation. One drives 
in the sheep, two others hold and brush them in the bath, and the 
fourth holds the head of the animal above the liquid. Tessier re- 
commended gloves for the use of the operators, but experience has 
shown that such a precaution is unnecessary. The udder, and par- 
ticularly the teats, of ewes with young may, if necessary, be smeared 



PSOROPTIC MANGE — SHEEP SCAB. 623 

with some fatty substance, such as vaselme or oil, in order to guard 
against the astringent action of the Hquid. 

Each sheep is plunged in the bath for one or two minutes, or five 
minutes at the most. All the diseased spots must be brushed, rubbed 
and cleansed ; but care must be taken not to make them bleed. 

Tessier suggested leaving the animals for twenty-four hours in 
some disinfected place, without straw or food, to prevent these 
materials from being wetted by the liquid which runs from the 
fleece, and which, if afterwards eaten, might have a poisonous effect. 
Here, again, the danger has been exaggerated. Delafond has shown 
that sheep may be given a fluid ounce of Tessier's bath for eight days 
running without producing the slightest unfavourable symptom. 

Tessier's bath is excellent from the therapeutic standpoint, but it 
imparts a yellow tint to the fleece, which is thus rendered less valuable. 
The mixture has therefore been modified in various ways. 

Clement's Bath (1846). 

{' Arsenious acid . . . . . . 1*5 parts or lbs. 

For 100 sheep . . . . J Sulphate of zinc. . . . . . 5 ,, 

( Water 100 

In this bath every quart contains about 2J drachms of arsenious 
acid. Its toxic power, therefore, is considerably greater than that of 
Tessier's bath. 

Clement's formula has one drawback. The sulphate of zinc may 
be mistaken for a non- astringent alkaline sulphate (sulphate of soda), 
and as a consequence poisoning may occur, as experience has shown. 

Mathieu of Sevres replaced the sulphate of iron by an equal 
quantity of alum. In this case, each quart of the bath contains 
2^ drachms of arsenious acid. 

Clement's and Mathieu's formulae have given just as good results 
as Tessier's. 

A last formula is that of Professor Trasbot. The aloes is of very 
little use, however, because it is almost insoluble. 

Arsenious acid . . . . . . . . 2 lbs. 

10 „ 
1 „ 
25 gallons. 



For 100 sheep . : . . Sulphate of zinc 

I Aloes 
^ Water . . 



Condition of the animals after the hath.~On leaving the bath 
the abraded parts are slightly cauterised. During the five or six 
following days the skin is stiff, and covered with adherent crusts 
over the points attacked by the parasites. The animals no longer 
scratch or bite themselves. 



624 SCABIES — SCAB — MANGE. 

Towards the eighth day the crusts fall, the skin appears supple 
and of a pink colour,- and the wounds cicatrise. In animals which 
have suffered for a long time recovery is much slower, and may 
extend over from thirty to fifty days. The wool again grows soft 
and bright, while the sheep rapidly regain their spirits and condi- 
tion. The cicatrisation of the wounds is often accompanied by intense 
itching, which must not be taken as a sign of the persistence of 
the disease. It is well, however, to keep the animals under observation 
at this period. 

Under any circumstances, six weeks or two months should always 
be allowed to elapse before giving a second bath. Should a few spots 
appear to be attacked secondarily, they may be moistened with a little 
of one of the bath liquids. 

In Germany the creolin bath is generally employed : 

^ ,^^ , ( Water .. ., ., 250 e-allons or parts. 
For 100 sheep.. - . | Creolin 6-5 

Each sheep is bathed a second time after an interval of one week, the 
animal being immersed for three minutes in the bath and thoroughly 
scrubbed with a brush. The efficacy of this method, however, is 
less certain. 

In America, where the flocks are large and scabies is frequent, 
sulphur baths are employed, the baths themselves being of great size. 
The animals are forced to pass through them and remain there for 
some minutes. 

The size and value of American, Australian, and New Zealand 
flocks demand that the modes of treatment practised and the experi- 
ence gained in these countries should receive something more than pass- 
ing notice. We therefore purpose giving a short resume of some parts 
of the very valuable monograph on sheep scab issued in 1897 by Dr. 
Salmon and Mr. Stiles, for the American Bureau of Animal Industry. 

In selecting a dip the question of expense will naturally arise ; 
next, the question as to whether or not scab actually exists in the 
flock to be dipped. The facilities at hand, the set-back to the 
sheep, and the length of the wool are also matters for considera- 
tion, as well as the pastures into which the dipped sheep are to be 
placed. 

Expense. — In estimating the expense one should consider not only 
the actual outlay for the ingredients of the ooze, but the cost of 
fuel and labour, the injury, if any, to the sheep, and the liability 
of not curing the disease. It is much more economical to use an 
expensive dip and cure scab, than it is to use a cheap dip and fail 
to cure it. 



PSOROPTIC MANGE SHEEP SCAB. 



625 



Does scab exist in the flock ^ — If scab does not actually exist and 
the wool is long, the dipping in this case simply being a matter of 
precaution, it is best not to select a dip containing lime. 

The facilities at hand for prejxiring dij). — If fuel is very scarce, 
so that it is impracticable to boil the mixture for at least two hours, 
the lime-and-sulphur dips should not be selected. 

The imstures. — In case it is necessary to place the dipped sheep 
on the same pastures they occupied before being dipped, it is always 




Fig. 256. — A comparatively early case of common scab, showing a bare spot 
and tagging of the wool. 



best to use a dip containing sulphur. If a proprietary dip is selected 
under those circumstances, it is suggested that sulphur be added, 
about 1 lb. of flowers of sulphur to every 6 gallons of dip. The 
object in using sulphur is to place in the wool a material which 
will not evaporate quickly, but will remain there for a longer period 
of time than the scab parasites ordinarily remain alive away from 
their hosts. By doing this the sheep are protected against reinfection. 
Sulphur is one of the oldest known remedies for scab ; its use 
is best known in the tobacco-and-sulphur dip and in the lime-and- 
sulphur dip. These home-made mixtures are the two dips which 

D.C. S S 



626 



SCABIES — SCAB — MANGE. 



have played the most important roles in the eradication of scab from 
certain EngUsh colonies, and their use is extensive in America. 

The Tohacco-and-Sulijhur Dip. 

The formula as given here, and as adopted by the New South 
Wales sanitary authorities, appears to have first been proposed in 




Fig. 257. — A slightly advanced case of common scab. 

1854 by Mr. John Kutherford. "On the Hopkins Hill Station Mr. 
Eutherford, with two dressings of these ingredients, then cured over 
52,000 sheep which had been infected for eighteen months. Since 
then millions of scabby sheep have been permanently cured in Victoria 
in the same way, and in South Australia and New South Wales 
hundreds of thousands of scabby sheep have also been cleansed with 
tobacco and sulphur. Judging, therefore, from the experience of the 
three colonies, there is no medicament or specific yet known that 
can be compared with tobacco and sulphur as a thorough and lasting 



PSOROPTIC MANGE — SHEEP SCAB. 627 

cure for scab in sheep." (Dr. Bruce, Chief Inspector of Sheep for 
New South Wales.) 

The proportions adopted by Eutherford, and afterwards made 
official by the scab sanitary authorities, are — 

Tobacco leaves . . . . . . . . . . . . . . 1 lb. 

Flowers of sulphur .... . . . . . . . . 1 ,, 

Water . . . . . . . . . . . . . . . . 5 gallons. 

The advantage of this dip lies in the fact that two of the best scab 
remedies, namely, tobacco (nicotine) and sulphur, are used together, 
each of which kills the parasites, while the sulphur remains in the wool 
and protects for some time against reinfection. As no caustic is used 
to soften the scab, heat must be relied on to penetrate the crusts. 

Directions for preparing the dip. — Infusing the tobacco : — Place 
1 lb. of gold-leaf or manufactured tobacco for every 6 gallons of 
dip desired in a covered boiler of cold or lukewarm water, and allow 
to stand for about twenty-four hours ; on the evening before dipping 
bring the water to near the boiling point (212^^ Fahr.) for an instant, 
then remove the fire and allow the infusion to stand overnight. 

Thoroughly mix the sulphur (1 lb. to every 6 gallons of dip 
desired) with the hand in a bucket of water to the consistency of 
gruel. 

When ready to dip, thoroughly strain the tobacco infusion from 
the leaves by pressure, mix the liquid with the sulphur gruel, add 
enough water to make the required amount of dip, and thoroughly 
stir the entire mixture. 

Lime- and- Sulpliur Dips. 

Under the term " lime-and-sulphur dips " is included a large 
number of different formulae requiring lime and sulphur in different 
proportions. 

To give an idea of the variety of the lime-and-sulphur dips, the 
following list is quoted, the ingredients being reduced in all cases to 
avoirdupois pounds and United States gallons : 

(1.) The original "Victorian lime-and-sulphur dip," proposed by 
Dr. Eowe, adopted as official in Australia : 

Flowers of sulphur . . . . . . . . . . . . 20| lbs. 

Fresh slaked lime . . . . . . . . . . . . lO^I ,, 

Water 100 gallons. 

"(2.) South African (Cape Town) official lime-and-sulphur dip, 
February 4th, 1897 : 

Flowers of sulphur . . . . . . . . . . . . 20| lbs. 

Unslaked lime . . . . 16f ,, 

Water . . ' 100 gallons. 

S S 2 



628 SCABIES — SCAB — MANGE. 

(3.) Fort Collins lime-and-sulphur dip : 

Flowers of sulphur . . . . . . . . . . . . 33 lbs. 

Unslaked lime . . . . . . . . . . . . . . 11 ,, 

Water . . . . . . . . . . . . . . . . 100 gallons. 

(4.) A mixture which, used to some extent by the Bureau of 
Animal Industry, contains the same proportions of lime and sulphur 
(namely, 1 to 3) as the Fort Collins dip, but the quantities are 
reduced to— 

Flowers of sulphur . . . . . . . . . . . . 24 lbs. 

Unslaked lime . . . . . . . . . . . . . . 8 ,, 

Water . . . . . . . . . . _ . . . . . 100 gallons. 

In case of fresh scab Formula No. 4 will act as efficaciously as 
the dips with a greater amount of lime, but in cases of very hard 
scab a stronger dip, as the Fort Collins dip, should be preferred ; 
or, in unusually severe cases, an ooze with more lime in proportion 
to the amount of sulphur, such as the Victorian (No. 1) or the 
South African (No. 2) dip might be used. 

Prejudice against Lime -and- Sulphur Dips. 

There is at present great prejudice (a certain amount of it justi- 
fied, no doubt) against the use of lime and sulphur, emanating 
chiefly from the agents of patent or proprietary dips and from the 
wool manufacturers. 

In the first place, it is frequently asserted that lime and sulphur 
does not cure scab. Experience in Australia and South Africa, as 
well as in America, has shown beyond any doubt that a lime-and- 
sulphur dip, when properly proportioned, properly prepared, and 
properly used, is one of the best scab eradicators known. 

It is claimed by some that it produces "blood poisoning." But 
the cases of death following the use of lime-and-sulphur dips have 
been infinitesimally few when compared with the number of sheep 
dipped in these solutions, and when compared with the deaths which 
have been known to follow the use of certain proprietary dips. The 
details of such accidents, so far as they have been reported, have 
not shown that death was due to any properly prepared and pro- 
perly used lime-and-sulphur dip. It is highly probable that the cases 
of so-called "blood poisoning" of shear-cut sheep are generally due to 
an infection with bacteria in stale dip containing putrefying material. 

The greatest objection raised against the use of lime-and-sulphur 
dip is that it injures the wool. This objection is raised by many 
wool manufacturers, and echoed with ever-increasing emphasis by 
the manufacturers of prepared dips ; while, after years of extensive 



PSOROPTIC MANGE — SHEEP SCAB. 629 

experience with properly prepared dip, its injury to the wool is 
strongly and steadfastly denied by the Agricultural Department of 
Cape Colony. 

It is believed that a certain amount of justice is attached to this 
objection , to lime and sulphur as generally used ; unless, therefore, 
lime and sulphur can be used in a way which will not injure the 
wool to an appreciable extent, we should advise against its use in 
certain cases ; in certain other cases the good accomplished far out- 
weighs the injury it does. Let us, therefore, examine into this 
damage and its causes. 

The usual time for dipping sheep is shortly after shearing, when the 




Fig. 258. — A more advanced case of common scab. 

wool is very short ; whatever the damage at this time, then, it can be 
only slight, and the small amount of lime left in the wool will surely do 
but little harm. 

In full fleece lime and sulphur will cause more injury. In Australia 
the deterioration was computed by wool buyers at 17 per cent., although 
in Cape Colony the Department of Agriculture maintains that if properly 
prepared, and if only the clear liquid is used, the sediment being thrown 
away, the official lime-and-sulphur formula will not injure the long wool. 
The- United States Bureau of Agriculture have found some samples of 
wool injured by dipping, while on other samples no appreciable effect 
was noticeable. 

If a lime-and-sulphur dip is used, care must be taken to give the 



6.30 SCABIES— SCAB — MANGE. 

solution ample time to settle; then only the clear liquid should be used, 
while the sediment should be discarded. In some of the above tests on 
samples of wool it was found that the dip with sediment had produced 
very serious effects, even when no appreciable effects were noticed on 
samples dipped in the corresponding clear liquid. 

Experience has amply demonstrated that a properly made and 
properly used lime-and-sulphur dip is one of the cheapest and most 
efficient scab eradicators known, but its use should be confined to flocks 
in which scab is known to exist, and to shorn sheep, with the exception 
of very severe cases of scab in unshorn sheep. It should only be used 
when it can be properly boiled and settled. The use of lime-and-sulphur 
dips in flocks not known to have scab, especially if the sheep are full 
fleeced, cannot be recommended ; in such cases tobacco, or sulphur and 
tobacco, is safer and equally good. 

All things considered, where it is a choice between sacrificing the 
weight of sheep and to some extent the colour of the wool by using 
tobacco and sulphur, and sacrificing the staple of the wool by using lime 
and sulphur, the owner should not hesitate an instant in selecting 
tobacco in preference to lime. The loss in weight by using tobacco and 
sulphur is not much greater than the loss in using lime and sulphur, 
while the loss in staple is of more importance than a slight discoloration. 

Preparation of the mixture. — Take 8 to 11 lbs. of unslaked lime, 
place it in a mortar-box or a kettle or pail of some kind, and add 
enough water to slake the lime and form a "lime paste" or "lime 
putty."* 

Sift into this lime paste three times as many pounds of flowers of 
sulphur as of lime, and stir the mixture well. 

Be sure to weigh both the lime and the sulphur. Do not trust to 
measuring them in a bucket or to guessing at the weight. 

Place the sulphur-lime paste in a kettle or boiler with about twenty- 
five to thirty gallons of boiling water, and boil the mixture for two hours 
at least, stirring the liquid and sediment. The boiling should be con- 
tinued until the sulphur disappears, or almost disappears, from the sur- 
face; the solution is then of a chocolate or liver colour. The longer the 
solution boils the more the sulphur is dissolved and the less caustic the 
ooze becomes. 

Pour the mixture and sediment into a tub or barrel placed near the 

* Many persons prefer to slake the lime to a powder, which is to be sifted and 
mixed with sifted sulphur. One pint of water will slake 3 lbs. of lime if the 
slaking is performed slowly and carefully. As a rule, however, it is necessary to use 
more water. This method takes more time and requires more work than the one 
given above, and does not give any better results. If the boiled solution is allowed 
to settle the ooze will be equally safe 



PSOROPTIC MANGE — SHEEP SCAB. 



631 



dipping vat and provided with a bung-hole about 4 inches from the 
bottom, and allow ample time (two to three hours, or more if neces- 
sary) to settle. 

When fully settled draw off the clear liquid into the dipping vat, and 
add enough water to make a hundred gallons. Under no circumstances 
should the sediment he used for dipping purposes. 

To summarise the position of the United States Department of 
Agriculture on the lime-and-sulphur dips: — When properly made and 




Fig. 259. — A shorn sheep with large bare area due to scab. 



properly used these dips are second to none and equalled by few as scab 
eradicators. There is always some injury to the wool resulting from the 
use of these dips, but when properly made and properly used upon shorn 
sheep, it is believed that this injury is so slight that it need not be con- 
sidered ; on long wool the injury is greater and seems to vary with 
different wools, being greater on a fine than on a coarse wool. This 
injury consists chiefly in a change in the microscopic structure of the 
fibre, caused by the caustic action of the ooze. When improperly made 
and improperly used the lime and sulphur dips are both injurious and 
dangerous, and in these cases the cheapness of the ingredients does not 



632 SCABIES — SCAB — MANGE. 

justify their use. In case scab exists in a flock and the farmer wishes to 
eradicate it, he cannot choose a dip which will bring about a more 
thorough cure than will lime and sulphur (properly made and properly 
used), although it will be perfectly possible for the farmer to find several 
other dips which will, when properly used, be nearly or equally as effectual 
as any lime-and-sulphur dip. There is no dip to which objections cannot 
be raised. 

Arsenical Dips. 

There are both home-made arsenical dips and secret proprietary 
arsenical dips. It is well to use special precautions with both, because 
of the danger connected with them. One of the prominent manufac- 
turers of dips, a firm which places on the market both a powder arseni- 
cal dip and a liquid non-poisonous dip, recently summarised the evils of 
arsenical dips in the following remarkable manner : 

"The drawbacks to the use of arsenic may be summed up somewhat 
as follows : (a) Its danger as a deadly poison, (h) Its drying effect on 
the wool, (c) Its weakening of the fibre of the wool in one particular 
part near the skin, where it comes in contact with the tender wool roots 
at the time of dipping, (d) Its not feeding the wool or stimulating the 
growth, or increasing the weight of the fleece, as good oleaginous dips do. 
(e) The danger arising from the sheep pasturing, after coming out of the 
bath, where the wash may possibly have dripped from the fleece, or 
where showers of rain, after the dipping, have washed the dip out of the 
fleece upon the pasture. (/) Its occasionally throwing sheep off their 
feed for a few days after dipping, and so prejudicing the condition of the 
sheep. ((/) Its frequent effect upon the skin of the sheep, causing exco- 
riation, blistering, and hardness, which stiffen and injure the animal, 
sometimes resulting in death." 

Although this manufacturer has gone further in his attack upon arsenic 
than the United States Bureau of Agriculture would have been inclined 
to do, it must be remarked that when a manufacturer of such a dip 
cannot speak more highly of the chief ingredient of his compound than 
this one has done in the above quotations, his remarks tend to discredit 
dips based upon that ingredient. Bruce, the Chief Inspector of Live Stock 
for New South Wales, speaking of arsenical dips, says: ''Arsenic and 
arsenic and tobacco (with fresh runs) cured 9,284 and failed with 9,271," 
It may be said, on tlie other hand, that arsenic really has excellent 
scab-curing qualities ; it enters into the composition of a number of the 
secret dipping powders, and forms the chief ingredient in one of the 
oldest secret dips used. This particular dip has been given second place 
(with some qualifications) among the officially recognised dips in South 
Africa. 



PSOROPTIC MANGE — SHEEP SCAB. 633 

Formvhe for arsenical dijys. — Finlay Dun recommends the follow- 
ing : — Take 3 lbs. each of arsenic, soda ash (impure sodium carbonate) 
or pearl ash (impure potassium carbonate), soft soap, and sulphur. A 
pint or two of naphtha may be added if desired. The ingredients are 
best dissolved in 10 to 20 gallons of boiling water, and cold water is 
added to make up 100 gallons. The head of the sheep must, of course, 
be kept out of the bath. 

A mixture highly endorsed by certain parties consists of the following 
ingredients : 

Commercially pure arsenite of soda . . . . . . 14 lbs. 

Gromid roll sulphm- .. .. .. .. .. 34| ,, 

"Water 432 gallons (U.S.) 

The arsenite of soda is thoroughly mixed with the sulphur before 
being added to the water. 

Precautions in use of arsenical mixtures. — Any person using an 
arsenical dip should bear in mind that he is dealing with a deadly 
poison. The following precautions should be observed : 

(1) Yards into which newly-dipped sheep are to be turned should 
first be cleared of all green food, hay, and even fresh litter ; if perfectly 
empty they are still safer. (2) When the dipping is finished, the yard 
should be cleaned, washed, and swept, and any unused ooze should at 
once be poured down a drain which will not contaminate food or premises 
used by any animals. (3) Dipped sheep should remain in an open, 
exposed place, as on dry ground. (4) Overcrowding should be avoided, 
and every facility given for rapid drying, which is greatly facilitated by 
selecting fine, clear, dry weather for dipping. (5) On no account should 
sheep be returned to their grazings until they are dry and all risk of 
dripping is passed. 

The feeling of the United States Bureau of Agriculture towards ar- 
senical dips is shown by the following : 

Suggestion as to danger. — The formulae given above are copied from 
the writings of men who have had wide experience in dipping, but this 
Bureau assumes no responsibility for the efficacy of the dips given, or 
for their correct proportions. Furthermore, as long as efficacious non- 
poisonous dips are to be had, we see no necessity for running the risks 
attendant upon the use of poisonous dips. 

Carbolic Dips. 

This class of dips kills the scab mites very quickly, but unfortunately 
the wash soon leaves the sheep, which is consequently not protected from 
reinfection in the pastures. If, therefore, a carbolic dip is selected, it is 



634 



SCABIES — SCAB — MANGE. 



well to add flowers of sulphur (1 lb. to every 6 gallons) as a protection 
against reinfection. 

The advantages of carbolic dips are that they act more rapidly than 
the tobacco or sulphur dips, and that the prepared carbolic dips are very 
easily mixed in the bath. They also seem, according to Gillette, to have 
a greater effect on the eggs of the parasites than either the sulphur or 
the tobacco dips. The great disadvantages of this class of dips are — first, 
in some of the proprietary dips, that the farmer is uncertain regarding 
the strength of material he is using ; second, the sheep receive a greater 
set-back than they do with either lime and sulphur or tobacco. 




Fig. 260. — An advanced case of common scab. 



The United States Bureau of Agriculture is inclined to be extremely 
conservative in regard to them, and to advise their manufacturers to 
prepare them in a guaranteed strength with more explicit directions for 
use than are to be found in the present circulars. 

One of the prominent proprietary carbolic dips was formerly recog- 
nised as one of the three official dips in New South Wales, but it has 
now been erased from the list. In Cape Town carbolic dips are. not 
much used, and in the official reports little is said concerning them. 

The United States Bureau of Animal Industry gives the following 
advice as regards dipping : 

(1.) Select a dip containing sulphur. If a prepared "dip" is used 
which does not contain sulphur, it is always safer to add about 



PSOROPTIC MANGE — SHEEP SCAB. 635 

161 lbs. of sifted flowers of sulphur to every 100 gallons of water, 




especially if, after dipping, the sheep have to be returned to the 
old pastures. 



636 SCABIES — SCAB — MANGE. 

(2.) Shear all the sheep at one time, and immediately after shearing 
confine them to one half the farm for two to four weeks. Many 
persons prefer to dip immediately after shearing. 

(3.) At the end of this time dip every sheep (and every goat also, 
if there are any on the farm). 

(4.) Ten days later dip the entire flock a second time. 

(5.) After the second dipping, place the flock on the portion of 
the farm from which they have been excluded during the previous 
four or five weeks. 

(6.) Use the dip at a temperature of 100° to 110° Fahr. 

(7.) Keep each sheep in the dip for two minutes by the watch — 
do not guess at the time — and duck its head at least once. 

(8.) Be careful in dipping rams, as they are more likely to be 
overcome in the dip than are the ewes. 

(9.) Injury may, however, result to pregnant ewes, which must 
on this account be carefully handled. Some farmers arrange a stage, 
with sides, to hold the pregnant ewes, which is lowered carefully into 
the vat, and raised after the proper time. 

(10.) In case a patent or proprietary dip, especially an arsenical 
dip, is used, the directions given on the package should be carried out 
to the letter. 

CHORIOPTIC MANGE, SYMBIOTIC MANGE, FOOT SCAB. 

This disease was studied in Germany by Ziirn in 1874, and by 
Schleg in 1877. It has not yet been seen in France. 

Causation. The sole cause is the presence of Cliorioptes scabiei 
{v. oris). Contagion is favoured by the animals being in poor con- 
dition. The disease extends very slowly. Only 2 to 3 per cent, of the 
animals are affected, and the sufferers are usually those with fine 
skins. 

German shepherds consider this disease to be due to an excessive 
allowance of salt, because it is most common during the winter, when 
the sheep are housed. Needless to say, this theory is incorrect. 

Symptoms. Sometimes this form of mange attacks the limbs and 
develops very slowly. It commences about the pasterns, and gradu- 
ally extends upwards towards the knee or hock. It really advances 
beyond these points. The parasites are much smaller than those of 
common scab, and are often overlooked. The sheep stamp their feet 
and scratch and bite the infected parts, sometimes transferring the 
disease to the lips and face, where it may ])ersist for a time.^ 

In very old standing cases which have been entirely neglected, 
it may be met with in the region of the armpit and thigh, the 



CHORIOPTIC MANGE, SYMBIOTIC MANGE, FOOT SCAB. 



637 




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638 SCABIES — SCAB — MANGE. 

limbs becoming swollen so as to suggest lymphangitis. In the folds 
of the hock and pastern the thickening of the skin may lead to the 
formation of yellowish or brownish crusts, according to whether 
the exudation is merely of a serous character or accompanied by 
bleeding. 

The diagnosis is easy. The parasites are found in the thickness 
of the crusts, and are readily recognised under the microscope. 

The prognosis is not grave, because of the comparative rarity of 
the disease and its mildly contagious character. This disease, more- 
over, never attacks the head or body, but remains localised in the 
lower portions of the limbs. 

Treatment. The crusts should be removed by washing or by stand- 
ing the animals for a time in warm water. Simple cleanliness often 
suffices, but, to save time, some anti-parasitic may be used. The con- 
dition is easily cured even without disinfecting the folds. 

MANGE IN THE OX. 

Bovine animals may be attacked by three varieties of mange, all 
of which have long been known. 

SARCOPTIC MANGE. 

This is not of any great clinical importance, as it is purely 
accidental, and only results from the conveyance of sarcoptes from 
other animals, such as the horse, sheep, dog, goat or cat, to an animal 
of the bovine species. That the disease does occur, however, is shown 
by the following excerpt from a report by Professor McFadyean : 
The animal showed no symptom of skin disease at the time of pur- 
chase, but soon after it was brought home it was noticed to be rub- 
bing, and the skin began to assume an unhealthy appearance. When 
seen in January (four months after purchase) it was rather poor, 
although it had been in very good condition when sold. Almost the 
entire skin had become affected, including that of the legs down to 
the top of the hoofs. There had been extensive loss of hair, and the 
skin was thick, grey, wrinkled, and dry. At some places it had become 
thrown into thick folds. Only a few scabs or crusts had formed where 
the animal had recently rubbed itself. In some scurf scraped from what 
seemed to be the parts most recently invaded, numbers of acari were 
without much difficulty found with the microscope. 

A good many cases of mange of undetermined character have been 
reported as occurring among cattle in various parts of England during 
the last year or two, and in a number of instances the disease was 
believed to have been contracted durins; exhibition at a show. It is 



PSOROPTIC MANGE. 639 

not imjDrobable that some or all of these were cases of this sarcoptic 
mange, and m view of its very contagious character it is desirable 
that care should be taken to exclude from shows animals exhibiting 
any symptom of the disease. 

PSOKOPTIC MANGE. 

This condition has also been termed dermatodectic mange. This 
is very rare, and, like the former, of trifling clinical importance. 

Causation. It is due to infection with Psoroptes communis {v. horis). 
Poor condition, want of grooming, bad hygienic surroundings and 
general neglect, facilitate its spread. 

Symptoms. It commences at the base of the neck, in rarer cases 
at the sides of the neck, along the withers, and at the root of the 
tail ; thence it gradually attacks the croup, loins, back, shoulders, 
sides of the chest, and finally all the body with the exception of the 
limbs. 

It produces violent itching, the animal continually scratching itself, 
even causing raw sores. At first the epidermis is elevated in little 
miliary points, which may be isolated or confluent, and are filled 
with serosity. This fluid discharges, gluing together the hairs ; it 
then hardens and produces adherent crusts, which increase in num- 
ber and size. The skin exhibits large numbers of bare, mangy points ; 
these have irregular margins, and are covered with thick, grey, scaly 
crusts. The psoroptes are found under these crusts. 

The skin becomes hard, dry, fissured and cracked, and sometimes 
forms large folds on the sides of the neck, shoulders and chest. 

The influence of the seasons on the development of this disease 
has been well shown by Gerlach and Muller. The disease commences 
about the end of autumn, when the animals are stabled. It continues 
to extend until February, but diminishes as soon as the animals re- 
turn to the fields in spring. The crusts fall, the hair again grows, 
and the animal appears to be cured, but the disease again revives 
during the autumn. The psoroptes lie hidden during the summer 
round the poll and the horns. The disease seldom attacks animals 
at grass and in good condition, or those over three years old. Calves, 
yearlings, and two-year-olds in poor condition suffer most. 

When the disease is very extensive, the animals lose condition 
and may even die. 

Diagnosis. Psoroptic mange in the ox may be mistaken for several 
cutaneous diseases, to which it has a certain resemblance, as for instance 
phthiriasis and the first stage of ringworm. 

These different diseases, however, show their own distinctive symp- 
toms on a careful examination. 



640 SCABIES — SCAB — MANGE. 

The prognosis only becomes grave when the disease has been 
neglected and the animals are greatly reduced in condition. When 
recent, this form of mange can readily be cured by the application 
of parasiticides. 

Treatment. As in dealing with all transmissible diseases, the 
animals must be isolated and washed with soap, and the diseased 
parts must be dressed with some parasiticide, such as sulphur oint- 
ment. The best preparations are : Benzine and petroleum in equal 
quantities ; concentrated solution of sulphuret of potassium (8 
ounces to the quart) ; Helmerich's ointment ; diluted creolin solu- 
tion ; decoctions of tobacco ; ointment of pentasulphuret of potassium, 
and oil of cevadilla. 

One or two applications are generally sufficient to effect a cure, and 
relapses are not likely to take place if the stable is disinfected. In 
America the disease is common in the West and North-West, where 
it is treated by the lime-and-sulphur bath recommended for sheep-scab 
(which see). Large vats are constructed, and the oxen are lowered into 
these by means of a wooden cage controlled by machinery, which is ope- 
rated either by a small engine or more frequently by a horse. 

The food should be of good quality, for good general health plays 
a great part in resisting parasitic invasions. 

CHORIOPTIC MANGE. 

This disease has also been termed dermatophagic and symbiotic 
mange. 

It was first described in 1835 by Kegelaar, and has been the sub- 
ject of investigation by Hering, Gerlach, Delafond, and Megnin. 

Causation. It is produced by the Chorioptes hovis, and is transferred 
with difficulty, even by co-habitation. 

Symptoms. This form of mange in the ox does not affect the same 
parts as in other animals. In the horse, etc., it attacks the limbs, whilst 
in the bovine species it is usually found at the base of the tail. It causes 
slight itching. The diseased region becomes covered with numerous 
little pellicles, the hairs gradually fall, crusts form, and the skin shows 
deep cracks. When the disease is completely neglected, it may extend 
to the loins, back, sides of the body and shoulders. It may also affect 
the perineal region, the inner surface of the thighs, and in fact the w^hole 
of the body if the animals are young and in poor condition. 

Diagnosis. At the outset it is difficult to distinguish between chori- 
optic and psoroptic mange, and the use of the microscope is necessary. 
On a superficial examination chorioptic mange may be mistaken for 
phthiriasis when the latter attacks the posterior portions of the body. 



SARCOPTIC MANGE. 641 

particularly the base of the tail, and when it is accompanied by erup- 
tions, loss of hair, and intense itchmg. 

The distinction between the two conditions, however, is extremely 
easy after an examination of the two parasites. 

Prognosis. The disease is of slight gravity, and does not threaten 
the animal's health unless neglected for so long a time that the para- 
sites invade all parts of the body. In that case the disease may 
cause anaemia and loss of condition. 

The treatment of this form of mange comprises nothing special, it 
being sufficient to proceed as directed in the previous article. 

The stables ought always to be thoroughly disinfected. 

MANGE IN THE GOAT. 

The goat suffers from the attacks of sarcoptes, psoroptes, and 
chorioptes, but up to the present time only two forms of mange 
have been described, sarcoptic and chorioptic mange. 

Psoroptes have only been found about the eye, where the disturb- 
ance they produce is comparatively trifling. 

SARCOPTIC MANGE. 

This disease was noticed in 1818 in goats imported into France 
from Thibet. 

Henderson published the history of a Persian goat which conveyed 
sarcoptic mange to men and horses. In 1851 Walraff noticed an epi- 
zootic mange which attacked the goats in the Prattigau valley of 
Switzerland, which was transmitted to men and sheep and w^hich 
exhibited the clinical characters of sarcoptic mange. 

Causation. This disease is due to the presence of Sarcoptes scahiei 
{v. caprcs). 

It sometimes occurs in an epizootic form, as Walraff's observations 
show, but it seems specially to attack goats in Asia and Africa. 

This mange may be transmitted by the goat to sheep, in which 
animals it attacks the head and muzzle ; it is particularly contagious 
in sheep having coarse, dry fleeces. 

Similarly sarcoptic mange of sheep may be conveyed to the goat, in 
which animal it extends all over the body. 

Symptoms. This mange causes intense itching. It first attacks the 
head and ears, then the trunk, belly, udder, and limbs. If the disease is 
neglected it becomes generaUsed very rapidly, and the animals waste 
away and die in a very short time. 

At the commencement little crusts, which discharge a viscous liquid, 
are found about the head. The goats rub themselves raw, and, as in 

D.C. T T 



642 SCABIES — SCAB — MANGE. 

facial mange of sheep, there appear dry, scaly, branlike patches. After 
a time the diseased area extends, the wool falls, and the skin becomes 
dry, thick and wrinkled. The appearance is exactly like that of sarcoptic 
mange in sheep, the lower part of the head being seldom invaded. The 
animals lose condition, waste and die of exhaustion. 

Diagnosis. The parasite is readily recognised, and the practitioner, 
moreover, is often put on his guard by the epizootic character assumed 
by the disease. 

The prognosis is grave. Walraff declared the mortality in Grisons 
(Switzerland) to be as high as 20 per cent. 

The treatment is identical with that of psoroptic mange in sheep. 
After the animals have been sheared and washed with soap, they should 
be completely immersed in a bath of the character mentioned in con- 
nection with sheep scab. If only one animal is infected, it may be 
sufficient to dress it repeatedly with an ointment containing some 
parasiticide. 

CHOmOPTIC MANGE. 

This form of mange was noted by Delafond in 1854 at the Jardin des 
Plantes (Paris) in some angora goats, and by Mollereau in 1889. The 
disease studied by Delafond had invaded both sides of the neck, the eyes, 
withers, back, loins, and base of the tail. It was characterised by partial 
loss of hair, the finer hair falling and the coarser remaining in position. 

In Mollereau's case the disease was located in one of the hind pas- 
terns, and assumed the form of a thickened band, which produced an oede- 
matous swelling. The chorioptes were discovered in a thick crust formed 
by the drying on the hair of the discharge due to their punctures. 

Diagnosis. The parasites can easily be found under the crusts, and, 
once recognised, distinguish the disease from any other infection. 

Treatment. Ointments containing some parasiticide and solutions 
of sulphuret of potassium generally suffice, the disease having little 
tendency to become generalised. 

MANGE IN THE Pia 

The pig suffers from one variety only of mange. It was described 
by Yiborg, Gurlt and Spinola, who found a sarcopt in the mange of 
wild boars in 1847. Hertwig and Gerlach made a similar observation 
some years later. Delafond in 1857 discovered the sarcopt of mange 
in the pig. 

Causation. Sarcoptic mange in the pig is due to the presence of 
Sarcoptes scahiei (v. suis), although the pig may contract (temporarily) 
the sarcoptic mange of goats. 

Contagion is favoured by poor condition, over-crowding, dirt and bad 
hygienic surroundings. 



DEMODECIC MANGE. 643 

The primitive races of pigs resist the disease better than the 
improved races. This mange can be conveyed to man and to other 
animals. 

Symptoms. It usually commences about the head, ears, and eyes, 
and extends to the quarters, internal surface of the thighs, etc. In the 
early phases it is impossible to discover the little galleries under the 
epidermis, but closely placed reddish papules may be seen. The active 
proliferation of the epidermis, together with discharge, causes the for- 
mation of dry crusts of a greyish-white, silvery tint, adherent while 
still thin, easy to detach at a later stage, and sometimes f of an inch 
in thickness. The skin becomes wrinkled, the bristles are shed or 
loosened in their follicles, and are glued together in little bunches before 
falling. As these patches extend over the whole surface of the body, the 
animal appears to be bespattered with dry guano (Muller). 

Under the crusts the skin is rough, excoriated, and, about the 
thorax and abdomen, is indurated, and sometimes measures 1 to IJ 
inches in thickness. In other parts, particularly at the base of the 
ears, the papillae are hypertrophied ; they become as large as a pea, 
or even a bean, and, lifting the crusts which cover them, assume the 
appearance of the warts sometimes found on the cheeks of dogs or the 
teats of cows. Sarcoptes may be found under these epidermic growths, 
though in order to obtain them the skin must be scraped until it almost 
bleeds. 

The dimensions of these parasites render them visible to the naked 
eye. They are the largest variety of the sarcoptinae, the egg-bearing 
female being half a millimetre in length. Guzzoni has found in the ears 
specimens of smaller size. 

Mange in pigs develops slowly. When it affects the whole body, it 
prevents fattening and causes loss of condition. 

Diagnosis. This is the only parasitic disease which affects the entire 
surface of the body and presents these peculiar powdery crusts. 

Treatment. All the styes should first be carefully disinfected. 
Treatment is commenced by vigorously scrubbing the animal with a 
brush dipped in soap and water, and thus getting rid of the crusts as 
far as possible. 

The animals are afterwards dressed with decoctions of tobacco, with 
Helmerich's ointment, or the other mixtures above mentioned. 



DEMODECIC MANGE. 

This mange is produced by parasites of the family Demodecidse 
{Demodex folliculorum) , which live in the hair follicles and sebaceous 
glands of several species of mammals. 

T T 2 



644 



SCABIES — SCAB — MANGE. 



DEMODECIC MANGE IN THE OX. 

This was described in 1845 by Gros, and in 1878 was found by Faxon 
in Illinois in the skins of cows prepared for tanning. It has not been 
met with in France. The skins examined by Faxon showed numerous 
rounded enlargements, resulting from dilatation of the hair follicles in 
the regions of the neck and shoulders. 

By pressing on these enlargements a whitish, greasy, sebaceous 
material was ejected, very rich in demodectes. 



This 

College, 




DEMODECIC MANGE IN THE GOAT. 

was first noticed by Niederhaiisern, at the Bern Veterinary 
in a goat which showed little nodosities over different parts of 

the trunk, varying in size between 
that of a pea and that of a hazel- 
nut. By forcibly compressing these 
enlargements a yellowish-grey semi- 
solid material, containing a consider- 
able number of demodectes, was caused 
to exude. 

In 1885 Nocard and Eailliet found 
the same parasite in a young he- 
goat ; the pustules w^ere spread over 
the sides and flank. Treatment con- 
sists in opening the pustules and 
dressing them a few times with an 
antiparasitic lotion. 




Fig. '263. — Demodex of the pig, 
magnified 250 diameters. (After 
Railliet.) 



DEMODECIC MANGE IN THE PIG. 

This was w^ell described for the 
first time by Csokor. It was after- 
wards seen by Neumann and Lindqvist. 

The isolated pustules are of the 
size of a grain of sand, but when confluent may reach the size of a 
hazel-nut. They are sometimes dark in colour, often deep-seated, are 
surrounded by a zone of inflammation, and appear in places where the 
skin is fine (the groin, neck, belly, etc.). The demodex becomes lodged 
and multiplies, not in the hair follicles, but in the sebaceous glands. 
Csokor regarded this disease as contagious ; in a herd of one hundred 
he found twenty-two pigs affected with it. Lindqvist, however, found 
but one case in a herd of tw^o hundred. 



NON-PSOilOPTIC FORMS OF ACARlASlS. 645 

NON=PSOROPTIC FORMS OF ACARIASIS. 

These are produced in farm animals by arachnide belonging to the 
families of Trombidiidae and Ixodidse. 

(1.) The Leptus autumnalis is considered to be the larva of the 
Trombidium Holosericcum, or silky trombidion. It lives in late summer 
and autumn, in the grass. 

Symptoms. The animals show intense itching, and cannot sleep 
owing to burning sensations. They continually rub themselves, and 
thus, secondarily, produce excoriated papules and patches resembling 
those of eczema. When the papules are very numerous, particularly 
if the animals are thin-skinned, more or less extensive erythema may 
be produced. 

At the points attacked the skin swells, becomes red, and sometimes 
even violet, and exhibits irregular, isolated or confluent swellings, \ 
to f of an inch in diameter. 

The parasite most commonly becomes fixed round the lips, the fore- 
head, the cheeks, the sides of the neck, and the extremities. 

The diagnosis is easy, the discovery of the parasite removing all 
doubt. 

The condition is of slight importance. The parasites do not live for 
more than a few days on the animal's skin, so that they only produce 
temporary disturbance. 

Treatment consists in bathing the parts with some lotion, such as 2 
to 3 per cent, creolin or 2 per cent, chloral, or in applying mixtures 
of oil and petroleum, etc. 

(2.) Ixodes hexagonus, I. ricinus, and other species of the tick family 
(Ixodidse) attack sheep, goats, and oxen in France. 

Symptoms. In sheep the ixodidae usually affix themselves at points 
where the skin is tender and unprotected by wool, as for instance the 
thighs, armpit, and upper part of the neck. Their bites produce irrita- 
tion, followed by an intense burning sensation, and the formation of a 
red blush round the point bitten. 

In the ox the ticks fasten on the neck, behind and within the ears, 
and also wherever the skin is tender. Until the last few years little 
importance was attached to their development, but since it has been 
proved that Rhipicephalus annulatus is the active factor in desseminating 
Texas fever, ticks have attracted much attention. 

It seems, moreover, to be proved by the researches of Lignieres that 
a form of piroplasmosis exists in France, and it seems possible that the 
Ixodes ricinus may be a means of propagation. 

The diagnosis of acariasis produced by ticks is easy, for the para- 
sites attain lar^^e dimensions. 



646 



SCABIES — SCAB — MANGE. 



Prognosis. It is difficult at present to say what importance should 
be attached to this form of acariasis, but its existence and possible 
consequences should be noted. 

Treatment. Some authors have recommended killing the ticks by 
touching them with benzine, petroleum, essence of turpentine, etc., but 
these methods do not always succeed. Applications of concentrated 
solution of chloral are more effective. When the parasites are so large 
as to render this possible it is better to remove them by hand, taking 
care at the same time to remove the rostrum, which, if left in place, 
might cause more or less suppuration. In countries where ticks are 




Fig. 264. — Ixodes ricinus. (After Eailliet.) A, Natural size ; B, ventral 
surface ; C, dorsal surface. 

numerous and large numbers of cattle are infested, the parasites are 
destroyed by smearing and dipping. 

(The cattle ticks of America are of especial importance in relation 
to the disease known as Texas fever. Those who wish to study the 
entomology of this subject are referred to the masterly account and 
fine coloured illustrations of Salmon and Stiles, " Cattle Ticks of the 
United States," Ann. Eep. U.S.A. Bureau of Agriculture, 1900, p. 380.) 



HYPODERMOSIS IN THE OX (WARBLES), 

Causation. This is a parasitic disease characterised by subcutaneous 
swellings due to the presence of larvae of the Hi/poderma hovis. The 
larva is met with throughout Europe. It attains the perfect stage 
during the summer, from the middle of June to the commencement 
of September. 



HYPOBERMOSIS IN THE OX (WARBLES). 647 

The female deposits her eggs on animals with fine skins. These 
eggs are elliptical, and provided with a kind of tail of a brownish 
colour. They soon become converted into larvae, provided with rows 
of little spines. 

The manner in which the eggs are laid is not exactly understood, 
nor are we better informed regarding the hatching of the young larvae. 
Until recently it was believed that the larva perforated the skin as soon 
as it quitted the egg, and then penetrated as far as the subcutaneous 
connective tissue. Kecent observations, however, have upset this view. 
It is probable that this larva, like other gastrophili, is swallowed by 
animals of the bovine species, and passes through the intestine into 
the surrounding tissues by a path which is yet unknown, possibly by 
the blood-vessels, whence it makes its way after a longer or shorter 
interval into the subcutaneous connective tissue. 

Certain recent observations seem to support the latter view, which 





Fig. 265. — A, Hypoderma bovis, natural size. B, larva of the lijpoderma 
escaping from a " warble." (After Kailliet.) 

is also corroborated by known facts regarding hypodermic myiosis 
in man. The eggs are laid in summer, and the swellings indicating 
the presence of the larvae only appear during the winter. Henrichsen 
found young larvae in the fatty tissue situated between the periosteum 
and spinal dura-mater, between the period from December to March. 

Symptoms. Whatever the mode of development of the larvae, 
cutaneous swellings appear between the months of February and 
March on the back, lumbar region, quarters, shoulders and ribs, and, 
less frequently, over the chest, belly and thighs. 

They vary in number. Commonly there are from ten to twenty, 
and it is only in rare cases that less than four or five are found. As 
soon as they attain the subcutaneous connective tissue they act as 
foreign bodies, causing a circumscribed inflammation, and finally sup- 
puration. In this way the so-called '• warbles " are produced. 



648 . HYPODERMOSIS. 

Each larva is surrounded by a thick wall, forming a cavity, which 
communicates with the outer air by a minute aperture. 

When the swelling is sufficiently advanced the larva may be extri- 
cated by pressing with the fingers around the base of the warble. A 
few days before it leaves its shelter the larva enlarges the little opening 
by thrusting its last rings into it. Soon after the larva has escaped 
the discharge of pus ceases, and the skin wound heals. 

Diagnosis. The times at which the swellings appear and the larvse 
are present render the diagnosis easy. 

Prognosis. This is seldom grave, for the larvae rarely cause death 
In cases where they are present in very large numbers, however, they 
may set up purulent infection. 

Treatment. No really effective treatment against warbles is known. 
Curative treatment consists in squeezing out or killing the larvae 
when in the subcutaneous tissue, but this is- practically useless, as 
the dead larvae then set up prolonged suppuration. 



CHAPTER III. 
RINGWORM, 

The old term " ringworm " is still used to indicate a well-marked 
skin disease due to parasitic fungi which grow at the expense of the 
epidermis. Other names, such as dermatophytis and epidermophytis, 
have been suggested, to indicate the mode in which the parasite 
grows. The term dermatomycosis suggests a cutaneous vegetable 
parasite. 

The dermatomy coses of the domestic animals are caused by fungi 
belonging to six distinct genera : — 

Trichophyton (horse, ass, ox, dog, pig) ; Eidamella (dog) ; Micro- 
sporum (horse, dog) ; Achorion (dog) ; Lophophyton (fowl) ; Oospora 
(dog). 

Eingworm is common in animals of the bovine species, but very 
rare in other domesticated animals, except, perhaps, the horse. It 
is caused -by the growth of a parasite, Trichoijhyton mentagrophytes 
(Eobin), of the genus Trichophyton, family Gymnoascea, order Asco- 
mycetes. 

The ascosporaceous form of reproduction is still unknown, but the 
mode of reproduction by conidia is characteristic. In cultures the 
mycelium is represented by growing filaments branching off at right 
angles, and by separate superficial aerial reproductive filaments of 
the conidian form. There is some reason for believing that these 
fungi may lead a saprophytic as well as a parasitic existence, i.e., 
that they can exist and multiply apart from the animal body. 

Their vitality is marked. Various experimenters have transmitted 
the disease with crusts kept for eighteen months. Thin declares 
that in two and a half years the spores had lost all power of germi- 
nation. They resisted immersion in water for two days, but were 
dead after eight days. Soft soap and 1 per cent, acetic acid kill 
them in an hour. 

Symptoms. The disease most frequently attacks young animals 
and milch cows — very rarely adults or old animals. This peculiarity 
is very difficult to explain. 

In calves, ringworm seems specially to attack the head, the 



650 



RINGWORM. 



'..Mt^ 



neigbourhood of the lips, the nostrils and sub-maxillary region, as 
well as the throat and neck. It assumes the form of circular 
patches, over which the hair stands erect. 

Gruby in 1842 discovered the parasite of tinea tonsurans, or 
herpes, and thus proved that the cutaneous lesions were not due to 
any constitutional condition, as was long thought, although dirt, bad 
hygienic conditions, and crowded stables favoured the spread of ring- 
worm. 

Direct contact between healthy and diseased animals and the 
transport of spores, by combs, brushes, etc., favour contagion. The 
disease may not only be conveyed from one animal to another of the 

same species, but from the ox to 
man, and, with somewhat greater 
difficulty, from the ox to the horse. 
Cases of transmission from the ox 
to the sheep, pig, and dog have 
also been recorded. 

Megnin in 1890 attempted to 
prove that all the trichophytons pro- 
ducing ringworm in animals do not 
belong to the same species, and gave 
the name of Trichophyton epilans to 
that usually found in the ox, be- 
cause it causes absolute loss of the 
hair by growing in the follicle, whilst 
he named the parasite found in the 
horse Trichophyton tonsurans, be- 
cause it only grows on the surface 
of the skin and in the thickness 
of the hair, without causing inflammation of the hair follicle and 
without invading it. 

The epidermis soon undergoes proliferation, and becomes covered 
with crusts, which adhere to the hairs, gluing them together, and 
finally causing them to be shed, leaving bare patches the size of a 
shilling or a florin. The lesion extends in an ever-widening circle, 
until it attains, perhaps, the dimensions of a five-shilling piece or 
more. 

The affected hairs break off level with the free surface of the 
skin, rendering the patches more apparent. White hairs are less 
affected, and some always remain projecting above the crusts, causing 
the patches, when on a white skin, to retain a certain amount of 
covering. 

At first the crust is closely adherent to the skin, and, if forcibly 




Fig. 266.— Calf suffering from 
ringworm. 



RINGWORM. 651 

detached, exposes the dermis, which is swollen and bleeding. Gradu- 
ally the centre becomes detached, whilst the periphery, representing 
a more recent lesion, continues to adhere. The crusts then rest on 
a thin layer of pus, and the dermis, whilst still inflamed, is punc- 
tuated with numerous minute apertures, representing the roots of the 
detached hairs. The pus lifts the crust ; gradually it dries up and 
forms superposed layers, which may or may not prove adherent to 
the parasitic products, and which form a new crust. The latter is 
purely inflammatory in character, and is left after the fall of the 
first. It no longer contains any parasites, at least within its 
deeper layers. 

This second crust dries up in its turn, falls away or breaks up, 
leaving a smooth spot, over which the hairs again appear, either at 
once, or at least after a short period of desquamation. 

The disease is accompanied by well-marked pruritus, more marked 
at the commencement and towards the end than during the inter- 
mediate period, but, nevertheless, much less acute than in scabies. 

Eingworm may undergo spontaneous cure in from six weeks to 
three months. It is more obstinate in calves than in adults, and 
the want of grooming tends to increase its duration. If it extends 
over a large part of the body the disease may seriously affect the 
animal's health, and the cases described by Macorps prove that where 
pruritus is violent it seriously aftects the animal's general condition. 

The patches may finally become confluent and the disease extend 
over the whole of the neck, shoulder and back, or it may attack the 
entire body, leaving it practically hairless. 

When the hair has been shed, the crusts and discharge seen at 
the outset disappear, and the bare spots are covered with a scaly 
coating, due to excessive production of epidermic cells. 

According to Gerlach, such crusts are thicker where the skin is 
black, and often exhibit a greyish-white, fibrous, starchy appearance. 
On unpigmented portions of the skin, which are usually thinner, the 
crust is less dense, and is slightly yellowish. Gerlach failed to re- 
inoculate the bare patches of skin left after a primary eruption of 
ringworm. Where the hair had again grown an eruption could again 
be produced, though it was usually of a feeble character. 

In a second form of the disease, the spots may be of very small 
dimensions. The hair falls away, but there is no exudative inflam- 
mation, and no formation of crusts. In this second form the animals 
simply show characteristic circular bare spots about the head, neck, 
or shoulders. 

Causation. The disease is due to the growth of germs on the 
skin of animals which are in a receptive condition. The parasite 



652 RINGWORM. 

thereafter develops in the hah's, the hair follicles and the epidermis, 
causing lesions which vary according to the species. 

At the present time three groups of ringworm are recognised as 
occurring on animals, Trichophytic, Microsporous, and Favus. 

Clinically the trichophytons are divided into the T. ectothrix, which 
lives outside the hair, and both outside and inside the hair follicles; 
T. endothrix, which penetrates the thickness of the hair itself, render- 
ing it brittle and easily destroyed ; and T. endo-ectotlirix, which both 
surrounds and invades the hair. 

The study of artificial growths of these fungi will probably afford 
valuable information on the above points. In the ox the particular 
parasite is invariably the Trichophyton mentagrophytes, whatever may 
be the characteristics of the clinical lesion. 

In France ringworm is particularly common in Auvergne and 
Normandy, where hygienic precautions are neglected, but cases may 
also be found throughout the country. 

After affecting cows throughout the winter, the disease often dis- 
appears in the spring. Throughout the winter cows are kept in dark 
and often filthy sheds, where the parasite propagates rapidly, whilst 
in spring they are sent to grass, where the conditions are inimical to 
contagion. 

Diagnosis. The diagnosis of ringworm seldom presents any diffi- 
culty. The appearance of the lesions (Fig. 266), their particular ten- 
dency to spread and contagious character, facilitate the diagnosis. 
They entirely differ from those of eczema or mange, and should any 
doubt exist, the slightest microscopic examination is sufficient to dis- 
sipate it. In ringworm in the ox the base of the hairs is covered 
with enormous numbers of spore chains, which do not extend into the 
depths. 

To detect the parasites it is best to shave off a thin fragment of 
skin from the periphery of the patch, place it on a slide with a drop 
or two of 30 per cent, caustic potash solution, and heat it for a few 
seconds almost to boiling point. By applying a cover glass with 
firm pressure the epidermal cells are spread out and the parasites can 
be seen, especially around the roots of the hairs. Sometimes they 
form little dirty-yellow masses, consisting almost exclusively of spores. 

When ringworm has attacked the entire surface of the body, it is 
much more difficult to distinguish from sebaceous eczema, and a 
microscopic examination or experimental inoculation may beconje 
necessary. Inoculation with ringworm material always succeeds 
with calves. 

Prognosis. Eingworm is not dangerous in itself. In time it may 
disappear spontaneously, but when it extends over the whole body it 



RINGWORM IN THE SHEEP, GOAT, AND PIG. 653 

may be dangerous. Owing to their bare condition the animals easily 
catch cold, while the epidermic proliferation is very great, and makes 
great demands on the animal's bodily powers. Under such circum- 
stances it is better to slaughter early. 

Spontaneous recovery from small lesions may occur in two or 
three months. 

Treatment. The patients should be isolated, and any brushes, 
combs, etc., with which they have been in contact must be dis- 
infected. 

The diseased areas should then be dressed with some fatty sub- 
stance, to soften the crusts and enable them to be removed without 
injury. 

Dressings are useless unless these crusts have been removed, for 
the spores are always in the deepest recesses and in the follicles, so 
that the drugs employed never come in contact with them. 

Once the skin is cleansed, numerous chemical substances may be 
utilised, the solutions being applied for several days in succession. 
Amongst them may be mentioned tincture of iodine, oil of cade, 
10 per cent, solution of sulphate of iron, and solution of perchloride 
of iron. Such drugs, however, must not be used for a long time, as 
they all attack the skin to some extent. 

When the patches are small and well defined the following mixture 
proves very efficacious : — • 

Crystallised carbolic acid . . . . . . . . \ 

Tincture of iodine . . . . . . . . . , > Equal parts. 

Chlorale hydrate . . . . . . , . / 

Two or three applications generally prove successful. 

Despite the natural activity of the spores, which are capable of 
germination after three months' desiccation, some medicines are use- 
ful, although it is necessary, in order to judge of their effects, to 
wait for the renewal of the skin, hair follicles, and hair. 

Where the disease is generalised this form of treatment is scarcely 
practicable, or at least it becomes more difficult. 

Nevertheless, by dressing with soft soap the disease may be cured 
in a few months. The soap should remain on the skin for some 
hours and then be washed off, after which dressings of creolin, lysol, 
or chloral solution, etc., should be employed. 



RINGWORM IN THE SHEEP, GOAT, AND PIG. 

Little information regarding the dermatomycoses of the sheep, goat, 
and pig is available. Allowing for modifications due to the nature 



654 RINGWORM. 

of the coat, the symptoms of recorded cases seem to indicate a close 
relationship with ringworm in the horse and ox. 

In sheep suffering from ringworm, the wool is at first matted into 
small irregular tufts, which grow larger and more numerous. The 
coat appears felted together at various points. The neck, chest, 
shoulders and back exhibit crustaceoas patches covered with bran- 
like epidermal scales, and the animals suffer from marked pruritus, 
which causes them to rub and injure the coat. 

Eingworm is very o])stinate in the goat. 

Two pigs described by Siedamgrotzky showed irregular, rounded 
patches, due to trichophyton, from 1 inch to 2 inches in diameter, 
reddish in tint, without exudation, but covered with abundant scales. 

In the pig ringworm attacks the croup, sides of the chest, flanks 
and sides of the abdomen, but is commonest on the back and out- 
side of the quarters. It forms red isolated patches, from 1 to 2 
inches in diameter, covered with miliary vesicles, which in turn are 
replaced by brown crusts. The bristles remain unchanged, and are 
not shed or broken. There is no pruritus. Contagion from pig to 
pig occurs readily. The disease may be conveyed from oxen to pigs 
through the medium of litter removed from the cowsheds to the 
piggery. 

Gerlach was unable to inoculate sheep or pigs with ringworm from 
the ox. Perroncito mentions a case of contagion from the ox to a 
lamb. Schindelka has seen sheep contract ringworm as a result of 
confinement to sheds previously occupied by oxen suffering from the 
disease. 

Siedamgrotzky successfully inoculated two pigs and two sheep with 
ringworm from the horse and a goat with the bovine form of the 
disease. The two pigs inoculated two others by contact. Contagion 
from the goat to the ox was noted in the canton of Ziirich in 1852. 

Fuller particulars on these heads will be found in a series of articles 
by Neumann in the Revue Veterinaire, January to June, 1905. 

In 1876 Laillier communicated to a French medical society a 
letter written by Lespiau describing an endemic of trichophyton dis- 
ease in the cantons of Ceret and Arles-sur-Tech. Thirty-four per- 
sons, including twenty-eight children, were affected. A dog was first 
attacked and seems to have inoculated a pig, which in these districts 
often lives with the human family. The pig inoculated the human 
beings. A moist season appears to have favoured the development 
of the disease. The parts principally attacked were the head, eye- 
brows, cheeks, and neighbourhood of the genital organs. The sub- 
jects showed considerable pruritus. 



CHAPTER IV. 
WARTS IN OXEN* 

Warts are cutaneous tumours, real papillomata, which most com- 
monly attack young animals such as heifers. As a rule they are 
pedunculated, smooth, wrinkled or deeply cracked on the surface, but 
in some cases they are sessile. 

Causation. The cause is difficult to ascertain. It has been referred 
to the growth of bacteria {Bacterium porri) in the superficial layers 
of the skin. It is at least certain that warts can be transmitted by 
inoculation or through the medium of cutaneous injuries. 

Symptoms. On their first appearance warts consist in hypertrophy 
of the cutaneous papillae, which become covered with layers of actively 
growing epidermis and end by projecting above the general surface. 
The lesions may remain isolated, or they may become confluent or 
unite at their base. This form is fairly common, the warts attaining 
the size of a man's fist or more. 

The disease attacks the most tender portions of the skin, such as 
that covering the udder, internal surface of the thighs, lower abdo- 
minal wall, region of the elbow, posterior surface of the ears, etc. 
In rarer cases warts may be seen on the limbs. 

When they extend over a considerable surface they become in- 
fected, suppurate and give rise to various complications, the most 
serious being pyaemia. The patients lose condition and value. 

Diagnosis. The diagnosis is easy. It has been proved that warts 
are contagious, not only as between animal and animal, but as 
between animal and man. 

Prognosis. Warts are not dangerous to life, but they diminish 
the value of the animals, particularly that of milch cows when the 
teats are affected. 

Treatment. Leaving out of account internal medication with cal- 
cined magnesia, many medicines that are still recommended are of 
comparatively little value. 

Peuch and Cruzel recommend friction with oil of cade. Eepeated 
cauterisation with nitric acid is declared to give good results by de- 
stroying the new tissue. 



656 WARTS IN OXEN. 

These modes of treatment, however, are impracticable in dealing 
with large multiple lesions, nor does the elastic ligatm^e give much 
better results. 

Total removal with the scissors or bistoury, or simply tearing out 
by hand, is preferable to any other course. Troublesome bleeding 
msij follow, but is rarely of great importance. It usually stops in 
a few minutes, even where small arteries of the size of several milli- 
metres in diameter have been divided. As a measure of precaution, 
however, the little wounds may be touched with the red-hot blade of 
the thermo- cautery. 

The ecraseur is rarely required. The smaller warts are generally 
sessile, and can be removed with a bistoury or a sharp curette. The 




Fig. 267. 

removal of those about the udder requires considerable precaution to 
avoid injuring the teats. 

All the growths are usually removed at one operation ; Moussu 
has thus taken away 30 lbs. weight without the slightest ill-effect. 
After the wounds have been washed with an antiseptic, the raw sur- 
faces are powdered with a mixture of equal parts of boric acid, tannin, 
and calcined alum ; cicatrisation occurs in a few days. 

URTICARIA IN THE PIG. 

This disease usually attacks pigs during the spring or summer, 
producing characteristic cutaneous lesions, which, however, are of a 



SCLERODERMA. 657 

benign character. It seems to arise from some form of alimentary 
intoxication. 

Symptoms. At first the dominant symptoms point to disturbance 
of digestion. The appetite is lost, and the bowels may be confined or 
there may be diarrhoea. This is sometimes accompanied by vomit- 
ing, and by fever. 

The symptoms may develop fully in from six to twelve hours ; 
sometimes the skin is covered with slightly prominent reddish 
patches, varying in size from J of an inch to IJ inches in 
diameter. 

The patches may also become confluent and form large, irregular 
red or violet flattened swellings, sensitive to the touch and spread 
over the upper and lateral portions of the body. Only in exceptional 
cases is there any oozing of blood. 

In favourable cases recovery takes place in forty-eight hours, and 
even in grave cases in from five to six days. 

Diagnosis. It is sometimes very difficult to distinguish this condi- 
tion from swine erysipelas, particularly in the first few cases, although 
the congested or hsemorrhagic patches occupy different positions. 

The prognosis is usually favourable. 

Treatment. The disease being unquestionably of digestive origin, 
the animals should be kept without food and receive repeated doses 
of mild j)urgatives according to their age and condition, sulphate of 
soda, 4 to 12 drachms, or calomel, IJ to 8 grains. Kecovery is 
rapid. 

SCLERODERMA. 

This term is applied to a disease characterised by thickening and 
hardening of the skin. Up to now it has been described only in the 
pig, and principally in male animals or old animals of either sex. 

The symptoms are difficult to detect, and in many cases are only 
discovered after slaughter. Without any change in external appear- 
ance, the skin becomes thick, hard and sclerosed over limited or 
extensive areas, and is thus transformed into hard, rigid, inextensible 
and inelastic plates, sometimes as much as 1 to 2 inches in thick- 
ness. The change usually commences about the dorsal region, and ex- 
tends irregularly towards the chest and sometimes towards the limbs. 

The patient thus becomes imprisoned in a kind of cuirass, which 
interferes with its movements and causes unaccountable stiffness. 
Palpation of the skin gives the impression of a piece of wood, for 
it is hard and resistant over the affected regions, whilst over the 
belly, inner surface of the thighs, and region of the elbow, it retains 
its usual pliability. 

D.C. U U 



658 SCLERODERMA. 

The patient exhibits no other symptoms, the principal functions 
of the body appearing to be properly performed. There is no fever, 
but in time the animals lose condition and waste away. 

Causation. This disease is also well known in man, but no 
general agreement exists regarding its nature. Some refer it to dis- 
turbance of the thyroideal function, though scleroderma is quite 
different to myxoedema. Others attribute it to changes in the cuta- 
neous blood-vessels, others, again, to peripheral neuritis accompanied 
by atrophic disturbance. Nothing, however, is proved. 

The apparent lesions are limited to hypertrophic sclerosis of the 
dermis, with progressive atrophy of the layers of subcutaneous adipose 
tissue. 

The diagnosis is comparatively easy. 

The prognosis is grave, because it is never known how rapidly 
the disease may develop. 

No method of treatment being known, the animals should at once 
be slaughtered. 



CHAPTER V. 
SUBCUTANEOUS EMPHYSEMA. 

By subcutaneous emphysema is meant the condition produced by 
the entrance of air or gas into the subcutaneous and interstitial con- 
nective tissue. Emphysema may remain localised or it may become 
generalised, according to the nature and extent of the lesion which 
causes it, and the points where emphysema is developed. Subcu- 
taneous emphysema is common in the sheep and ox. 

Symptoms. Sometimes the symptoms of subcutaneous emphysema 
are extremely well defined. They consist in the presence of diffuse or 
limited crepitant swellings which may appear at various points — in the 
flank or the entrance to the chest ; more rarely in the region of the 
elbow, etc. 

The limits of crepitation may be ascertained by palpation, while 
percussion produces a peculiar abnormal sound. The subcutaneous 
tissue and very often the interstitial tissue appear as though 
blown out. 

Emphysema may be generalised. Such an accident is rare, but 
may occur in the ox as well as in the sheep and goat. 

Provided the emphysema remains confined to the subcutaneous 
tissue, the animals are not necessarily in danger. Where, however, 
it also extends to the interstitial tissue, and particularly if the cause 
to which it is due continues, death may result in a very short time. 
This occurs, for example, when the emphysema extends into the 
mediastinum, and thus gains the pleura and lung. 

The symptoms of emphysema are then complicated with respira- 
tory and circulatory disturbance and with signs of asphyxia. 

Causation. Subcutaneous emphysema may be produced in many 
different ways. 

If, for example, in puncturing the rumen the canula be carelessly 
withdrawn so that the skin is slightly separated from the subjacent 
tissues, gas may pass from the rumen into the channel produced by 
the instrument. It then becomes distributed throughout the sub- 
cutaneous tissue, and if the cutaneous opening is displaced its escape 
is confined to the connective and interstitial tissues in the region of 

u u 2 



660 SUBCUTANEOUS EMPHYSEMA. 

the flank. Diffuse suppuration may then be set up in these parts, 
and may extend far beyond them. 

In the ox emphysema rarely becomes generalised, but in the sheep 
and goat extension is more common ; the patients perish of intoxi- 
cation, caused by reabsorption of septic gases. 

Under other circumstances emphysema may be due to an injury 
in some region where the connective tissue is loose and pliable, as for 
instance the region of the elbow, the internal surface of the shoulder, 
or the fold of the flank. Every time the animals move the tissues 
are displaced, and air being drawn in, it is imprisoned by the valve- 
like action of the injured part and gradually finds its way into the 
subcutaneous tissue. 

Accidental injuries to the trachea, particularly injuries produced by 
dogs biting sheep or goats, are always accompanied by local emphy- 
sema, unless the wounds in the skin and trachea correspond, which 
rarely happens. At every respiration a portion of the air expelled 
passes into the peritracheal tissue, from which it gradually invades 
neighbouring parts, and may attain the mediastinum, etc. The 
injured animal thus inflates its own tissues and dies from asphyxia. 

The open lesions due to pulmonary echinococcosis, and the acci- 
dents associated with pneumo-thorax, tuberculous caverns and abscesses, 
or pulmonary emphysema may become points of departure for local, 
general, interstitial or subcutaneous emphysema. 

The diagnosis of accidental emphysema presents no difficulty, for 
the local swellings can only be mistaken for those of blackquarter. 
In the latter disease, however, fever is a constant accompaniment, 
whilst in simple emphysema it is absent. 

Nevertheless, it is well to remember the possibility of complications 
due to compression, asphyxia, and even intoxication. 

The prognosis may be very hopeful or very grave. Everything 
depends on the primary lesion, and it is therefore important that the 
practitioner should know how to interpret the course of affairs. 

Treatment. In slight cases the best method is to immobilise the 
parts and await developments, but in grave cases, for instance where 
the trachea is much injured, the animal should at once be slaughtered. 

Scarification, cutaneous incisions, and massage were formerly 
recommended as a means of aiding the escape of gas accumulated 
in the tissues. Such methods, however, are useless, and have the 
disadvantage of causing numerous suppurating wounds. 

Provided the initial wounds are not seriously infected and the 
animals are kept quiet, in a well-ventilated place, the gas gradually 
becomes reabsorbed, and healing may take place in a fortnight or 
three weeks. 



SECTION IX. 
DISEASES OF THE EYES. 

In domesticated animals, apart from parasitic diseases, the diseases 
of the eye which particularly deserve description and offer a special 
clinical interest are very few. These are the diseases that affect the 
globe of the eye or the organs annexed to it. 

FOREIGN BODIES. 

Foreign bodies become lodged on the internal surface of the eyelids, 
in the folds of the conjunctiva, in the thickness of the cornea, and some- 
times, though rarely, in the anterior chamber, the lens, or the vitreous 
humour. They include particles of grit or dust, the awns and glumes 
of grain, etc. 

The eyes are half closed and the conjunctiva is swollen, whilst the 
eye weeps and the animals dread the light. 

Diagnosis. This is somewhat difficult, for the parts rapidly become 
very sensitive, and the animals violently resist examination. "When the 
foreign body penetrates the anterior chamber or the lens, it produces 
suppuration or traumatic cataract. 

Before anything can be done it is often necessary to render the 
parts anaesthetic by instilling a few drops of cocaine solution into 
the eye. 

The foreign body may then be discovered by close observation. 
If the pain is very intense, and great resistance is offered to opening 
the eye, the practitioner may confine himself to passing a soft camel- 
hair brush saturated with cocaine solution over the surface of the 
eye and into the conjunctival sacs. The brush loosens, and often 
removes, the offending body. In the absence of a camel-hair brush, 
the little finger, covered with a piece of fine linen, may be used. 

Where' the parts cannot be touched owing to the resistance of the 
animal, lukewarm solutions of antiseptics such as boric acid may be 
occasionally injected into the eye by means of a syringe, but care 
must be taken to prevent the animal injuring itself against the 
syringe by sudden movements. 



662 DISEASES OF THE EYES. 

CONJUNCTIVITIS AND KERATITIS. 

Inflammation of the conjunctiva and inflammation of the cornea 
almost always occur together, and reciprocally induce one another 
when of a certain degree of intensity. They may be simple, that is 
to say, produced by simple causes, or they may be specific, and 
of a contagious character. 

Simple inflammation is caused ■ by the action of cold, draughts, 
dust, or mechanical injuries. Specific inflammations, the nature of 
which is still little understood, occur in the ox and goat. They are 
very contagious, and may successively attack all the animals of a 
herd. 

The symptoms of acute and specific inflammation differ very little. 
They comprise congestion, lachrymation, chemosis, a certain amount 
of suppuration, and sometimes superficial ulceration of the cornea. 
The patients suffer very acute pain, avoid the light, present all the 
symptoms of photophobia, and are affected with spasm of the 
orbicularis muscle. 

In simple cases these symptoms frequently disappear, provided 
the byres are kept clean and astringent eye-washes are applied. 

In contagious keratitis, however, the cornea may suppurate and 
even become perforated after a few weeks. 

Treatment. The chief object of treatment under any circumstances 
must be to insure the most perfect cleanliness both of the globe of the 
eye and the conjunctival sacs. 

The eye must, therefore, be irrigated with lukewarm water, the 
stream being injected beneath the lids. Each irrigation is followed 
by the use of an anodyne and astringent eye-wash containing borate 
of soda or sulphate of zinc, combined if necessary with cocaine. 

Distilled water . . . . . . . . . . . . 100 parts. 

Borate of soda . . . . . . . . . . . . 4 ,, 

Hydrochlorate of cocaine . . . . . . . . . . 1 ,, 

But saturated solution of boric acid is simple, and no less effective. 

In contagious keratitis the eye lotion may contain 2 bo 3 per 
cent, of nitrate of silver, the excess of silver being neutralised by 
washing out with a weak solution of common salt. After three or 
four applications this should be changed for a saturated solution of 
boric acid. 

VERMINOUS CONJUNCTIVITIS. 

This form of conjunctivitis, described by Eodes in 1819, is due to 
the presence of the Filaria lachrymalis, which varies in length between 
I of an inch and 1 inch. 



VERMINOUS OPHTHALMIA OF THE OX. 663 

Like ophthalmia, the disease attacks cattle reared in wet localities. 

Symptoms. The symptoms are those of acute conjunctivitis, and 
consist first of lachrymation, then of injection of the blood-vessels of 
the conjunctiva, together with swelling of the eyelids and photophobia. 
The animals keep the eye closed, and display extreme sensitiveness. 
Here again cocaine proves of value. 

Examination is rather difficult, the w^orms being sometimes dis- 
placed towards the cornea or membrana nictitans, although more 
commonly they remain hidden in the folds of the mucous membrane 
towards the point where the membrana nictitans is inserted. It is, 
therefore, necessary to thoroughly expose the folds of the mucous 
membrane in order to discover them. 

In time conjunctivitis becomes complicated with diffuse ulceration, 
keratitis, and sometimes with ophthalmia and suppuration of the eye. 

Diagnosis. The diagnosis is rather troublesome, and cocaine is of 
great assistance. 

Prognosis. This is rather grave. 

Treatment. The object of treatment is the complete removal of 
the parasites. This can sometimes be attained by means of the finger, 
a pair of forceps, or a very clean feather. 

Treatment is completed by injecting an antiseptic and anti- 
parasitic eye lotion for several days, lest some of the worms should 
remain hidden in the folds of the mucous membrane. One per 
cent, creolin or 1 in 2,000 sublimate solution may be used. 

If in some exceptional case it is difficult to remove the parasites, 
they may be got rid of by injections or free irrigation. The stream 
of liquid, pointed in different directions, distends the mucous mem- 
brane and washes away the foreign bodies on its surface. 

VERMINOUS OPHTHALMIA OF THE OX. 

This ophthalmia is due to the presence of a small worm, f of an 
inch to IJ inches in length, which has been regarded as the larval 
form of the Filaria cervina of the serous cavities. 

It is very common in animals which are kept permanently in low- 
lying meadows particularly in some parts of France, as for instance 
in Normandy, in the departments of the Sarthe and the Mayenne. 
Not infrequently it occurs as an epizootic, and is then regarded as 
a contagious ophthalmia. Verminous ophthalmia occurs chiefly 
during the spring and autumn. 

Symptoms. The disease is accompanied by lachrymation, signs 
of conjunctivitis, and fear of light. Very soon the media of the eye 
become turbid, the sclerotic and cornea are injected, and finally 
exhibit marked opalescence. 



664f DISEASES OF THE. EYES. 

On examination the eye appears extremely sensitive ; in fact, it 
can scarcely be touched unless cocaine solution is previously applied. 

The parasites, two or three as a rule, but in exceptional cases 
from five to seven in number, are seen rolled up within the anterior 
chamber of the eye. A week after the beginning of the attack, how- 
ever, they begin to move about, and are then found close behind the 
cornea, upon the lens, or suspended in the aqueous humour. 

The irritation produced sets up inflammation of Descemet's mem- 
brane and the cornea, together with iritis, and, secondly, keratitis 
and changes in the lens. 

Unless treatment is adopted verminous ophthalmia inevitably 
ends in cataract. 

Diagnosis. Diagnosis is always uncertain on account of the diffi- 
culty of examination. When the cornea is very opaque examination 
necessarily gives a negative result. 

The prognosis is grave. 

Treatment. Eye lotions containing tincture of aloes, creolin, 
corrosive sublimate, etc., have been suggested, but are practically 
useless, because they can have no action on a parasite enclosed 
within the globe of the eye. The most logical treatment consists in 
aseptic puncture of the anterior chamber of the eye towards its lower 
border with a cataract needle. 

The escaping liquid carries with it the parasites, and recovery is 
then only a matter of time, provided the wound does not become 
inflamed. The great danger consists in inflammation and suppura- 
tion of the eye. This, however, can be avoided by antisepsis and by 
applying a surgical wool dressing, which can be left in place for a 
few days. 



SECTION X. 
INFECTIOUS DISEASES. 

COW-POX— VACCINIA, 

The name cow-pox, or vaccinia, is employed to describe a special 
disease which in animals of the bovine species is characterised by 
the development of pustules at points where the skin is fine, and 
more particularly the mammary region. 

It can be conveyed both to man and the domestic animals. 

This disease has been known from time immemorial, and it would 
appear that first of all in the East and later in England it was a 
general belief that its attacks rendered human beings proof against 
small-pox. Medical men, it must be admitted, long regarded this 
belief as a popular delusion, as is proved by their continuing to 
practise inoculation with true small-pox material. 

Jenner in 1770 was the first to declare the truth of this popular 
opinion, and by his wise foresight to confer on humanity one of the 
most beneficent discoveries ever made, although the weight of modern 
opinion is in favour of the identity of cow-pox and human variola. 
Having observed that milkmaids who happened to have ■ small cuts 
or sores about the hands sometimes contracted the disease in a mild 
form, and that they did not afterwards suffer from small-pox, he was 
struck with the advantages consequent on such a discovery, and having 
proved the possibility of inoculating human beings artificially, he 
immediately formulated the principles of vaccination. A child eight 
years of age was vaccinated with cow-pox, and afterwards inoculated 
with pus from a small-pox patient. It contracted vaccinia in con- 
sequence of the first inoculation, but entirely resisted the attempt to 
inoculate it with small-pox. Vaccination had been discovered. 

Jenner furthermore proved that cow-pox was transmissible from 
cow to cow and from man to man, but it seemed to him that the 
original disease was to be sought elsewhere, and that the pustular 
affection originated primarily with the horse. The horse is some- 
times the subject of a pustular disease called horse-pox ; this disease 
when inoculated in man confers immunity against small-pox, just as 
does cow-pox, and Jenner believed that the disease did not .attack 



666 INFECTIOUS DISEASES. 

COWS unless they had been accidentally inoculated through the medium 
of the people about the farm. Unfortunately, he named the pustular 
disease of the horse which he had studied " sore heels," and for a 
long time all those who busied themselves with the question of vaccine 
confounded " sore heels " with a number of different diseases, although 
as early as 1802 Loy had experimentally proved that so-called " grease " 
(in reality horse-pox) was transmissible by inoculation to the cow, in 
which it produced cow-pox. 

Loy's "grease" and Jenner's "sore heels" only represent forms 
of horse-pox, but for more than fifty years the origin of vaccine was 
sought in grease, lymphangitis, and other diseases which attack the 
extremities of horses' limbs. Petelard (1845-1868) rediscovered and 
redescribed horse-pox and proved its transmissibility to man; Lafosse 
and U. Leblanc discovered it in an epizooty which broke out at 
Eieumes ; and Bouley in 1862 furnished a synthetical description of it 
under the designation of horse-pox. He shows that horse-pox is always 
a pustular disease, but that it may sometimes appear in the form of 
a discrete eruption around the lips and nostrils, sometimes of an erup- 
tion limited to the pasterns or extremities of the limbs when inoculation 
has been effected in this region, sometimes of lymphangitis, and some- 
. times of a more or less confluent and generalised eruption. 

Symptoms. The disease as discovered and described by Jenner 
was soon rediscovered and redescribed on all sides — by Sacco in Italy, 
Hering in Germany, etc. 

The pustular eruption usually appears on the udder in the case 
of cows, and on the muzzle, nose, and lips in that of calves. In 
exceptional cases the eruption may become generalised. 

The pustules are round or slightly elliptical, and are preceded by 
the appearance of red congested patches, followed by infiltration and 
thickening of the skin. 

The pustule is moderately prominent, and after some days there 
is exudation at its centre, transforming it into a vesico-pustule. The 
exuded liquid collects under the thickened layer of epidermis, which 
it raises, and on examination it appears as a white or transparent 
little central patch, with a thin grey periphery surrounded by a reddish 
inflammatory zone. This liquid becomes thicker and the pustule is 
flattened at its centre, then, towards the eighth or ninth day, the 
pustule is ruptured, owing to tearing of the epidermic patch. The 
vaccine thus escapes. 

In what is termed spontaneous vaccinia the udder is covered with 
a varying number of pustules, usually in different stages of development. 
Some are very small, whilst others have attained the size of sixpence 
and are already in course of cicatrisation. 



COW-POX — VACCINIA. 667 

When cow-pox is accidental or the result of inoculation, the eruption 
occurs exactly at the point of inoculation, whether the latter has been 
through an abrasion, a puncture, an incision, or any other skin injury, 
and the eruption may assume the most varied appearances, according 
to the nature of the primary lesion, although the mode in which the 
pustules themselves form never varies. Pustules experimentally pro- 
duced by puncturing the parts may be taken as a type of inoculation. 
On the day following the operation nothing abnormal appears. On 
the third day there is a slight swelling around the point punctured, 
and this increases until the fifth day, when there is exudation, which 
converts the primary lesion into a vesico-pustule. On the sixth day 
the vesico-pustule becomes umbilicated at its centre, the exudation is 
abundant, and already vaccine might be collected. 

This may be termed the period of crisis ; the appearances are most 
characteristic. During the following days the vesicle is ruptured ; the 
discharge continues from the ninth to the twelfth day, when the pustule 
diminishes in size and dries up. After the fifteenth day crusts of a 
brownish colour form ; these separate betw^een the twentieth and 
twenty-fifth days, leaving hard whitish-looking cicatrices, which per- 
manently^ remain. 

Moderate itching accompanies the development of the eruption, the 
principal functions are not disturbed, and fever only appears in the 
^vent of the eruption becoming confluent or extending over a large 
area. When the eruption is generalised the pustules or vesico-pus- 
tules are found mostly in the region of the elbow, the lower border 
of the neck, the flank and the inner surface of the limbs. They 
present exactly the same appearance as the pustules on the surface 
of the udder, but, being covered with hair, are less open to inspection. 

In certain rare cases the eruption extends to the perineum and 
lips of the vulva. Signs of inflammation then develop on one or both 
sides, the tissues display oedematous infiltration and disseminated or 
confluent pustules. The lymphatic glands and vessels in the neigh- 
bourhood of the pustules are always swollen. 

Causation. Cow-pox, or vaccinia, is a virulent disease transmissible 
by accidental or intentional inoculation. The discharge from the vesico- 
pustules and the crusts which afterwards cover them are virulent, 
and inoculation can be performed by simply scratching the skin. A 
first attack confers prolonged and sometimes perfect immunity, the 
operation being successful if only one pustule develops. 

The disease is transmitted to healthy anim.als by milkers, by calves 
in sucking, or by the conveyance in whatsoever form of virulent material 
to sores or cuts. 

The nature of the parasitic or microbic agent which produces the 



668 INFECTIOUS DISEASES. 

disease is still unknown. Some investigators have described intra- 
cellular parasites, others extra-cellular parasites, others, again, blood 
parasites, etc., but the exact cause has always eluded research. 

It is, however, known that filtration of vaccine, pure or diluted, 
through porcelain removes the active material, which remains in the 
residue arrested by the filter. 

Prolonged exposure to a temperature above 104° Fahr. (40° C.) 
greatly diminishes the activity of the vaccine. Simple desiccation has 
no action. Warming to 140° Fahr. (60° C.) for fifteen minutes also 
destroys its action completely. 

These facts explain why it has always been so difficult to preserve 
and cultivate vaccine in tropical regions. 

Mixed with equal parts of neutral glycerine, the virulent material 
preserves its activity unimpaired for from six to eight months. 

The disease develops equally in man, the horse, the ox, the buffalo, 
the goat, and the camel. Its development is less typical in the pig, 
sheep, dog, and rabbit. Young animals are best adapted for its 
cultivation. 

The blood and serum of animals suffering from cow-pox possess 
immunising properties, but only when administered in very large 
doses, say from 6 to 12 lbs. of blood, or ^ to 1 lb. of serum. 

The curative action of this serum against small-pox is compara- 
tively trifling. 

The diagnosis of cow-pox is not very difficult. 

At first the disease might be mistaken for false cow-pox, the erup- 
tions of foot-and-mouth disease, or gangrenous cor3^za. 

In false cow-pox, the nature of which is also little understood, 
although it is known to be contagious and is regarded by some as 
true vaccinia, the pustules are smaller and thinner, while the vesicle 
is more developed, and the disease runs a more rapid course. 

In foot-and-mouth disease the eruptions are of the nature of 
vesicles or bullae, not pustules. The eruption occurs in twenty-four 
hours or less, and can only be mistaken for vaccinia during the 
period of desiccation and the formation of crusts. 

Finally, as regards gangrenous coryza, the hardened pustules do 
not produce vesicles. 

The prognosis is generally favourable. The disease runs its course 
within relatively fixed periods, according to the development of the 
pustules, and recovery occurs without complications. 

Treatment. No curative treatment can be laid down, the develop- 
ment of the disease being perfectly regular and tending to recovery. 
Simple hygienic precautions and cleanliness are sufficient to avoid 
complications due to suppuration. 



COW-POX AND HUMAN VARIOLA — PREPARATION OF VACCINE. 669 
COW-POX AND HUMAN VARIOLA — PREPARATION OF VACCINE. 

Time and experience having proved that inoculation with cow-pox 
or vaccinia protected human beings against small-pox, the question 
arose as to the connection between the two diseases, whether or not 
they were identical and whether vaccinia m the bovine animal might 
not merel}^ represent an alternative form of small-pox. The importance 
of the question will at once be understood by bearing in mind the 
danger to which human beings would be exposed by vaccination with 
small-pox virus unmodified by passage through the calf. 

Nevertheless, at the present time the opinion of the early writers 
appears to prevail, and the theory of identity is accepted by the great 
majority of scientific men. The reason why experimenters in the 
second group came to believe in duality is that the method of inocula- 
tion chosen (by puncture) was not entirely reliable. The inoculations 
proved too slight, and it is only after inoculation by scarification or 
incision that typical eruptions can be reproduced in series. 

Preparation of Yaccine. Whether cow-pox and small-pox are or 
are not identical, the benefits resulting from vaccination are none 
the less real, and it is to be hoped that vaccination and revaccina- 
tion will soon be made obligatory in all countries. We should then no 
longer have to deplore those epidemics of small-pox which periodically 
cause consternation in large cities and colonies. 

The preparation of vaccine has been the subject of such minute 
care in every country that neglect of vaccination is astonishing. The 
material is obtained from calves or cows. In France the vaccine is 
prepared from animals of five to eight months old, free from disease. 
The old system of inoculation by puncture has been completely 
abandoned, the yield being insufficient, scarifiications or incisions being 
now employed. 

The animal is secured or, better still, laid down on a suitable table, 
and is shaven over a sufficient surface. The inoculations are made on 
the sides of the chest, over the thorax or elsewhere, but preferably over 
the flank and thorax, as being most readily accessible. The region of 
operation is rendered aseptic as far as possible, and scarified in lines 
about 1 to 2 inches in length, the lines of one horizontal row alter- 
nating with those in the next. It is imperative that the slight bleeding 
which may result should entirely cease before inoculation is attempted. 

The scratches are inoculated with the purest vaccine obtainable, 
preferably with glycerinated pulp which has been kept for six weeks 
or two months. From the third day the lines of inoculation become 
prominent, and an indurated longitudinal swelling, with all the charac- 
teristics of a pustule, soon projects above the neighbouring portions 



670 INFECTIOUS DISEASES. 

of skin. On the fifth day exudation commences, and from the sixth to 
the seventh day a large quantity of vaccine lymph may be collected. 
The Une of inoculation appears slightly umbilicated and surrounded 
by a greywish-white zone and a hard peripheral swelling. 

Vaccine may be collected from the fifth day in summer to the 
eighth day in winter. 

The inoculated area having been cleansed with boiled water and 
carefully dried, the little crusts covering the inoculation wounds are 
loosened and the wounds themselves gently scraped with a special 
curette of small size. The exuded liquid is very active. 

The base of each swelling is then grasped in a little special clamp, 
which acts like a pressure forceps and causes the discharge of a farther 
large quantity of active vaccine lymph. All the material thus obtained 
is mixed ; an equal quantity of neutral glycerine is added, the whole 
is finely triturated, passed through a cloth, and stored in little sterilised 
glass tubes, which are hermetically sealed. 

The vaccine thus prepared retains its activity for from five to eight 
months, if kept from the action of heat and light. Accidental germs 
which may have developed in the wounds and thus gained entrance 
to the vaccine gradually lose their activity. After from forty to sixty 
days the vaccine may be regarded as absolutely pure and incapable 
of producing accidental suppuration, as sometimes occurs when fresh 
vaccine is employed. 

The old electuaries, dried vaccines, vaccine pastes, etc., have been 
almost entirely given up, the above method always yielding a pure 
and active vaccine. Vaccination with calf lymph should always be 
preferred to vaccination from arm to arm, in view of possible trans- 
mission of grave disease, such as syphilis. 

TETANUa 

Tetanus is a disease characterised by tonic contraction of the 
muscles of one or more limbs or of all the muscles of the body. 

Causation. It is due to the growth of Nicola'ier's bacillus in some 
part of the body (in accidental wounds, in the uterine cavity after 
parturition, etc.), and the contraction of muscles is due to toxins 
(elaborated by the microbe), which have a selective affinity for the 
nervous centres. 

These toxins, secreted by bacilli localised in wounds, are absorbed 
and carried away by the lymphatic and vascular channels and dis- 
tributed throughout the body. They seem chiefly to affect the cells of 
the central nervous system. Infection is due to microbes capable of 
living as saprophytes outside the animal body. 



TETANUS. 671 

Nicolaier's bacillus assumes the form of a straight rod, one end of 
which is swollen by the presence of a spore. It is anerobic, grows in 
a number of different media, most rapidly at a temperature of 100° to 
102° Fahr. (38° to 39° C), and stains well by Gram's method. 

Though quite common in the horse, tetanus is rare in other 
domestic animals. 

In the ox it may result either from mechanical injuries, suppu- 
rating sores, or surgical operations. In the cow, goat, and sheep it 
sometimes assumes the form of a true enzooty after parturition if the 
byres, etc., are not disinfected. In male animals it principally follows 
castration by one of the cutting methods, and in lambs is seen after 
amputation of the tail. A large number of animals belonging to one 
flock may be affected, and Moussu has known two-thirds of a given 
number of castrated lambs to die of tetanus. 

Despite the sensitiveness of domesticated animals to tetanic infec- 
tion they may all be protected, either by injections of cultures, or by 
gradually increasing injections of specific toxin. The latter, however, 
are more efficacious when modified by the addition of terchloride of 
iodine or of iodine water. The blood of immunised subjects rapidly 
acquires antitoxic powers, which may be greatly increased for the pur- 
pose of obtaining an ti- tetanic serum. 

The symptoms of tetanus are the same in all species. 

In the first stage the animal appears stiff, walks in a jerky way 
and holds the head high, with the ears pricked. The eyes are 
slightly withdrawn into the orbits, and the animal shows marked 
general excitability. 

In the second stage there are muscular contractions, together with 
trismus, stiffness of the neck, limbs and vertebral column, spasm of 
the spinal muscles and muscles of the limbs (tonic contraction), and 
the animal has a peculiar, staring look. 

In the third stage mastication becomes difficult or impossible, 
respiration is impeded, and the animal suffers from spontaneous 
attacks of muscular contraction or from attacks due to external 
stimulation (noises, sudden movements, changes from darkness to 
light, etc.). 

In the fourth stage the animal is liable to fall, asphyxia threatens, 
and death occurs from respiratory syncope. 

Eecovery is quite exceptional in the sheep, goat, and ox; death 
usually occurs between the second and sixth days. 

Diagnosis. Tetanus being less common in the ox, sheep, and goat 
than in the horse, the diagnosis is not so easy in these animals, but 
as it develops under different conditions, and as it usually attacks 
several animals in one byre or fold, the diagnosis is rarely very 



672 INFECTIOUS DISEASES. 

difficult. At the worst some hesitation may be felt at first, the 
condition being mistaken for disease of the brain. 

The prognosis is extremely grave. 

The treatment is, above all, of a preventive nature, investigation 
having proved that injections of anti-tetanic serum, before the first 
appearance of tetanus, are invariably effectual. 

If, therefore, one case of tetanus appears in a byre at calving time 
or in a flock at the season when the lambs are castrated, no hesitation 
should be felt in preventively inoculating all the castrated animals and 
the cows which have calved. The quantities required are, for a cow 
10 cc. (about 3 fluid drachms) and for a sheep 5 cc. of anti-tetanic 
serum. 

This treatment, however, should be supplemented by general 
hygienic precautions and internal treatment, such as irrigation and 
disinfection of the parts affected. 

Curative treatment has little chance of success. Experiments have 
also proved that when the first symptoms of tetanus appear, anti-tetanic 
serum is powerless to prevent the development of the disease. Never- 
theless, as its gravity is in direct ratio to the quantity of toxin absorbed, 
and as the degree of this absorption depends on the length of time that 
the place remains infected, the first thing to be done is to disinfect 
and, in certain cases, curette the wounds which are believed to be the 
source of mischief. Although antiseptics have little action on Nico- 
laier's bacillus, they may be used. Solutions of iodine appear most 
active, both as regards ordinary wounds and infection of the uterus. 

General tonics, diuretics, and lukewarm gruels can be given. Un- 
fortunately the patients are often unable to swallow them. In such 
cases both liquids and medicines may be directly introduced into the 
rumen by puncturing the parts with a trocar and canula, the latter 
being left in position. 

Intravenous injections of large quantities of normal salt solution 
are also of considerable value, 4 to 6 quarts per day for an ox 
and 20 to 40 fluid ounces per day for a sheep. 

ACTINOMYCOSIS. 

Actinomycosis is a disease produced by a fungus belonging to the 
group of oomycetes (Actinomyces hovis) which develops in the depths 
of living tissues in man and the ox, producing grave and sometimes 
incurable lesions, most commonly in and about the jaws. 

Actinomycosis is very common in America, and is also met with 
in all parts of Europe. 

Symptoms. The disease assumes many different clinical forms, but 



ACTINOMYCOSIS OF THE MAXILLA. 



673 



it more frequently attacks some parts of the body than others, and 
by far the greater number of cases occur in the ox. 




ACTINOMYCOSIS OF THE MAXILLA. 

Actinomycosis of the maxilla attacks young animals, and its usual 
seat is in the molar region, although occasionally it affects the incisors. 

The earliest symptoms consist in swelling of the bone, which may 
be overlooked if within the mouth, but the outline of the jaw soon 
becomes deformed, generally in the middle region of the row of molars. 
Somewhat tender and firm to the touch at first, the tumour gradually 
increases in size, invades the 
deeper regions of the skin, 
and displays fluctuation at 
one or two points, followed 
by abscess formation. The 
pus discharged ma}^ be white, 
creamy, and inoffensive, but 
the cavity of the abscess 
shows no tendency to cica- 
trise, and the opening through 
which the pus has escaped is 
transformed into a fistula. 
From this moment the pus dis- 
charge is of a greyish, sanious 
nature, and contains a greater 

or less number of little yellowish grains. It soon acquires an offen- 
sive odour, and the fistulous opening is surrounded by exuberant granu- 
lations, forming a fungoid mass. 

The neighbouring tissues become hardened and lose their sensitive- 
ness, the jaw becomes completely deformed, and a condition is set up 
which the old writers considered as true cancer of the jaw or maxillary 
osteosarcoma (Fig. 268). 

A probe passed into the fistula penetrates deeply, usually into the 
thickness of the jaw itself, and however carefully manipulated injures 
the diseased tissues and causes free bleeding. 

If neglected, these lesions become steadily worse, mastication is more 
difficult, being possible only on the healthy side, and the animals lose 
condition and eventuall}^ die of exhaustion. The external lesion, repre- 
sented by the fungoid mass, increases in size, assumes a blackish colour, 
and discharges an offensive liquid. Portions of it undergo mortifica- 
tion and give off' a characteristic and extremely foetid odour. The 
molars become loose and in some cases fall out, but development is 

D.C. X X 



Fig. 268. — Actinomycosis of the jaw. 



674 



INFECTIOUS DISEASES. 



usually slow, and some weeks or months elapse before this stage is 
reached. 

When the disease attacks the region of the incisors the symptoms 
are much sooner apparent, and treatment is much easier. The parasitic 
invasion results from an injury to the jaw caused by shedding of the 
milk teeth. Swelling of the body of the jaw thrusts the lower lip 
downwards, interferes with the prehension of food, and calls for 
prompt treatment. The disease is rarely allowed to attain the degree 
of development shown in Figs. 269 and 270. 

As in the preceding instance, the animals die of exhaustion unless 
relieved. 

For reasons difficult to explain, but probably because inoculation 





7t 



'-^^ 



'%■ 



\ 



Fig. 269. — Actinomycosis in the region 
of the incisors. 




Fig. 270. — Actinomycosis in the 
region of the incisors. 



is less easy, actinomycosis is much rarer in the upper than in the 
lower jaw. The disease develops exactly as above described, but 
shows much less tendency to external ulceration. It invades the 
maxillary sinus and the region of the palate, and fistulBe are found 
opening into the buccal cavity, while at the same time the region of 
the forehead is often deformed. 



ACTINOMYCOSIS OF THE TONGUE. 



Actinomycosis attacks the tongue apart from any lesion of the 
jaws, and produces what is commonly called "wooden tongue." 

The disease develops in the tongue itself, generally in the sub- 
mucous zone, and causes chronic interstitial inflammation, infiltration 



ACTINOMYCOSIS. 



G75 



of the connective tissue, and, in time, changes in the muscular struc- 
tures themselves. 

The tongue shows progressive hypertrophy, and becomes hard, sensi- 
tive, rigid, and incapable of free movement. As a result the patients 
first have difficulty in grasping food, then in swallowing their saliva, 
which dribbles from the mouth, and finally are quite unable to feed 
themselves. 

The tongue is enlarged and indurated, and fills the entire cavity 
of the mouth. Sometimes it projects beyond the incisors, excoriated 
and bleeding. On passing 
the hand into the mouth it 
is found that the surface is 
covered with little yellowish 
or red ulcerated nodules, 
varying in size from that of 
a large pin's head to that of 
a lentil. 

In eating, the animals 
seize food between the lips 
and lift the head high, so 
as to allow the food to fall 
between the rows of molars. 
The motion is very similar 
to that of a fowl drinking. 

ACTINOMYCOSIS OF THE PHARYNX, 
PAROTID GLANDS AND NECK, 

Actinomycosis may some- 
times leave the mouth and 
tongue unaffected and attack 
the pharynx, from which it 
extends in the direction of 

the parotid glands and external surface of the neck. In these cases, 
however, the inoculations are more localised than when the surface 
of the tongue is attacked, and the lesions consist of vegetations, polypi, 
or actinomycomata. 

The growths develop on the posterior pillars of the fauces, on the 
sides of the pharynx, or near the entrance to the oesophagus. They 
interfere with swallowing, and produce symptoms which are easy to 
detect and interpret. 

The lesions may also affect deeper- seated tissues and produce 
growths in the parotid or subparotid region, or lead to the develop- 
ment of fistulse in the region of the neck. Most fistulae, however, in 

X X 2 




Fig. 271 — Actinomycosis of the tongue. 



676 



INFECTIOUS DISEASES. 



this region are due to specific inoculation of external injuries. Fistulse 
originating in the parotid region and in the upper part of the neck 
usually resemble in appearance the maxillary fistulae. The external 
fungoid growth, however, is less exuberant, suppuration is less abun- 
dant, and the surrounding induration less extensive. 

Various localisations. Although the disease generally attacks the 
mouth, tongue or pharynx, it may invade the oesophagus, rumen. 




\ 



Fig. 272. — Actinomycosis of mamillary gland (cow). 



reticulum, liver and intestine, larynx, trachea, lung, peritoneum, 
epiploon, and even the udder. 

Localisations in the udder and peritoneum are commonest in pigs, 
and it is believed that inoculation occurs either through the galacto- 
phorous sinuses or through the abdominal wounds made for purposes 
of castration. 

Causation. The cause of actinomycosis is to be sought in the 
development of Actinomyces hovis within living tissues. It seems pro- 
blematical whether the germs to be found in the pus or saliva of 
affected animals ever directly infect new hosts, and it is difficult to 
carry out infection in this manner even in very sensitive experimental 



ACTINOMYCOSIS. 



6?: 



animals. Nevertheless, the persistence of the disease in certain bvres 
would seem to support the view of direct infection. 

On the other hand, it is proved that the actinomyces is a parasite 
affecting vegetables, principally the graminacese, and that domestic 
animals are most commonly infected through injuries caused by vege- 
table substances. This is suggested by the discovery of the debris 
of grain at the point where the lesions have originated. 

Inoculation is commonest in the mouth and on the surface of the 





Fig. 273. — Actinomycosis of mammary gland (cow), showing growth 
invading lobules. (Figs. 272 and 273 are from blocks kindlj^ 
supplied by Mr. Gilruth, F.E.C.V.S.). 

tongue, parts which are, so to speak, permanently excoriated. The 
shedding of the temporary molars favours such accidents, and this is 
why actinomycosis of the jaw is, relatively, so common. The incisor 
region may also be inoculated during the shedding of the milk teeth, 
but as the infected food comes more closely and for much longer 
periods in contact with the molars, it is easy to understand why 
actinomycosis is rarer in the incisor region. 

The conditions are less favourable for inoculation of the pharynx, 
because food does not remain in position there for more than a 



678 



INFECTIOLTS mSEASES. 



second or two, but when the epithelium has been shed as a conse- 
quence of laryngitis or pharyngitis, infection may occur. 

As regards cutaneous inoculation, the parasite only seems dan- 
gerous when the skin is excoriated or injured either accidentally or 
as the result of surgical interference. 

Actinomycosis of the lung is probably caused by the germs being 

inhaled along with 
the inspired air. 

Lesions. The 
lesions are very pe- 
culiar in character, 
and end in com- 
pletely destroying 
the tissues invaded. 
Once lodged 
within an organ, 
the disease shows 
a tendency to ex- 
tend in all direc- 
tions, and, despite 
the defensive reac- 
tion of the tissues, 
it soon forms 
numerous parasitic 
centres. 

In bones, for 
example, actinomy- 
cosis invades the 
spongy tissue with 
the greatest ease. 
It causes subacute 
ostitis, which leads 
to diffuse suppura- 
tion and local 
hypertrophy of the bone, destruction of the compact layers, and the 
development of an abscess with fungoid, exuberant, granulating walls 
which show no reparative tendency whatever. 

The pus of the abscess and the liquid from the fistula contain 
varying quantities of yellowish grains, representing clusters of actino- 
myces. The surrounding tissues, muscles, tendons, skin, etc., are all 
involved before long in the inflammatory process, and the granulating 
masses themselves are invaded by the yellowish parasitic tufts. All 
the fistulae are surrounded by enormous zones of infiltration, which on 




Fig. 274. 



-Old-standing bone lesions in a case of 
actinomycosis of the jaw. 



ACTINOMYCOSm. 



679 



incision exhibit a lardaceous appearance. On section it may appear 
that the lesion is confined entirely to the bone, though this is excep- 
tional (Fig. 274). Ordinarily the neighbouring tissues are also de- 
stroyed, and not infrequently there is communication with the ex- 
ternal air. Sections then display a fungoid tissue, interspersed with 
perforated lamellae of bone and lardaceous tissue containing cavities 
crammed with actinomyces. 

The lesions in the parotid regions, the neck or other parts attacked 
always present the same appearance, viz., wide, tortuous, bifurcated 
fistulae, with exuberant granulations both in the direction of the cavi- 
ties and of the exterior, together with lardaceous induration of the 
tissues and abundant foetid liquid 
pus. 

When it affects the tongue the 
parasite is to be found in the sub- 
mucous region, where it causes 
little swellings, which, when super- 
ficial, rapidly undergo ulceration. 
The subjacent regions, the inter- 
stitial connective tissue, and the 
muscular tissue become infiltrated, 
hardened and progressively scle- 
rosed. The tongue is gradually 
hypertrophied, and soon it becomes 
as hard as wood, whence the term 
''wooden tongue." 

Actinomycosis of the lung 
may easily be mistaken for tuber- 
culosis, for the centres, although 

usually confined to one lobe, may also be disseminated. The lesions, 
however, are surrounded by an abundant fibro-sclerous inflammatory 
tissue. 

In the abdominal cavity, particularly in sows, actinomycotic lesions 
occur as little masses varying in size between that of a pea and that 
of a haricot bean, attached to the epiploon and peritoneum and filled 
with pus containing mycosic grains. 

Diagnosis. Actinomycosis is usually easy to recognise, both on 
account of the special character of the lesions and the presence of 
the little grains formed by the parasite. The practitioner will rarely 
fail to recognise at once the signs of actinomycosis of the jaw, but 
actinomycosis of the tongue is more apt to be mistaken for deep-seated 
sclerosing glossitis, although a careful examination will always enable 
the different symptoms to be distinguished. 




Fig. 275. — Highly-magnifiecl clump 
of actinomyces. 



680 INFECTIOUS DISEASES. 

It is otherwise with regard to growths in the pharynx and oesophagus, 
for, until after removal, simple polypi cannot be distinguished from 
actinomycotic growths. In such cases the administration of iodide of 
potassium affords valuable indications. 

The prognosis is grave, whatever the clinical form of the disease. 
Important advances, it is true, have lately been made, and the iodide 
of potassium treatment is of great value, but too much must not be 
expected of it, and its benefits have certainly been exaggerated. Clinical 
experience suffices to prove that only actinomycosis of soft tissues can 
be cured by drugs, bony lesions being amenable only to medical and 
surgical treatment combined. Even combined treatment is often un- 
successful. 

Treatment. Thomassen in 1885 first explained the favourable action 
of iodide of potassium on actinomycotic growths, and Nocard in 1892 
again directed public attention to the advantages attending the use 
of this drug both in man and the lower animals. As too frequently 
happens, however, the benefits of this treatment have been exagge- 
rated, and iodide of potassium has been held out as a specific even 
against lesions in bone. With very few exceptions this is incorrect, and, 
as Moussu has shown, when the disease affects bone tissue it only 
yields to mixed treatment. 

The treatment of actinomycosis may therefore be considered under 
two heads. 

Firstly, the treatment of actinomycosis of soft tissues ; and, secondly, 
that of bone. 

Actinomycosis of soft tissues, muscle, skin, lymphatics, serous mem- 
branes, etc., comprises the most common forms of actinomycosis, viz., 
those of the tongue, pharynx, parotid glands, neck, etc. 

The second form comprises actinomycosis of the lower jaw (molar 
region), the upper jaw, region of the incisors, etc. 

Iodide of potassium in daily doses of from 2 to 3 drachms is almost 
a specific in dealing with the first form of disease. 

In lingual actinomycosis, for example, the effects may be seen a 
few days after treatment is begun. The tongue becomes softer and 
more mobile, can be protruded beyond the mouth and retracted into it, 
and day by day tends progressively to resume its normal appearance. 

The patients, which were previously slowly dying of inanition be- 
cause they were unable to feed themselves, again take to their food 
and begin to put on flesh. To ensure the treatment being efficacious 
it should, as a rule, be continued for three or four weeks. 

During the course of this treatment the system becomes saturated 
with the drug, but no bad effects follow. The patients suffer from 
lachrymation, coryza, bronchorrhsea, and especially iodic eczema, but 



ACTINOMYCOSIS OF BONE. 081 

ail these symptoms diminish and disappear soon after the adminis- 
tration of the drug is discontinued. 

Kecovery, however, is not always permanent, and even when the 
tongue has resumed its normal appearance a relapse may occur. We 
have seen several such cases after treatment extending over more than 
six weeks, and it is therefore often advisable to fatten the animals as 
rapidl}^ as possible and prepare them for slaughter. 

If no relapse occurs, and recovery is regarded as permanent, 
another complication may make its appearance, viz., sclerous atrophy 
of the tongue. This is almost as dangerous as the primary lesion, 
because it prevents the animals from feeding, and constitutes an addi- 
tional reason for following the course above suggested. 

Other lesions of soft tissues, such as disease of the parotid or cer- 
vical glands, etc., yield to the same treatment, but it is advisable first 
of all to clean out the fistulae, scrape off exuberant granulations, cleanse 
the irregular culs-de-sac, and thoroughly curette all accessible parts. 

Treatment is much longer than in the case of actinomycosis of 
the tongue, but it is not always necessary to push the remedy to 
extreme limits. As soon as symptoms of iodism appear only a drachm 
or two of the drug need be given daily. 

Actinomycosis of Bone. — As a general rule, actinomycosis of bone 
resists the administration of iodide of potassium, a fact probably ex- 
plained by the much less abundant blood supply in bone as com- 
pared with very vascular tissues, such as the tongue. 

To have any chance of success the iodide treatment must be sup- 
plemented by surgical interference. As regards the surgical aspect 
of the case, the affected bone should be removed as far as possible, 
together with all broken-down tissue. Should this be neglected, the 
disease returns in a little while. 

In actinomycosis of the region of the incisors the method is radical 
when adopted in time. The body of the maxilla can be partially 
removed with a fine saw, two cuts being made disposed thus : < (the 
letter V sideways). The upper and lower layers of compact tissue 
should be spared as much as possible, so that the body of the bone 
may not afterwards break. Recovery is only a matter of time. 

A very small local iodoform dressing is applied, and, when healthy 
granulations appear, cicatrisation can be left to natural means. 

Cases of actinomycosis of the jaw are much more troublesome. If, 
as usually happens, the lesion is ulcerated before the practitioner is 
called in, the external fungoid growth should be removed by means 
of an elliptical incision through the skin, the axis of the ellipse being 
parallel with the branch of the maxilla. The bony fistula is then 
exposed. 



682 INFECTIOUS DISEASES. 

In following up this fistula care must be taken not to injure the 
facial artery, the facial vein, or Stenon's duct. Once the bone is 
exposed the disease can be attacked in the depths. The diseased 
interior is cut away by means of a special curette, all affected por- 
tions being removed, and an iodine or iodoform dressing is then 
applied. 

The operation is extremely troublesome, owing to the enormous 
bleeding, and sometimes it is impossible to carry out successfully, 
as in the case of old-standing and extensive lesions. To ensure 
recovery under such circumstances, it is necessary to remove a por- 
tion of the branch of the jaw, and this, though quite possible from 
the scientific standpoint, would not be worth while in an animal, the 
value of which is usually small. 

Curettage of the bone is only of value in dealing with recent 
lesions, and even then should not be practised except in the case of 
animals which the owmers particularly desire to keep. 

In cases of actinomycosis of the upper jaw surgical treatment is 
just as difficult as in the lower jaw, and calls for similar precautions. 

The diseased portions of bone having been removed, the cavity is 
plugged with iodoform or cotton-wool, or a dressing saturated with 
boric acid and iodoform. 

In all surgical operations it is important not to injure the dental 
arteries or nerves, or the alveolo-dental periosteum. 

TUBERCULOSIS. 

Tuberculosis is a contagious disease produced by the action of 
Koch's bacillus. It is common to man and all domesticated animals, 
but it specially affects animals of the bovine species. Its existence 
has long been recognised, although in oxen it was formerly con- 
founded with the lesions of peri-pneumonia and echinococcosis. 

It was not until the beginning of the nineteenth century that 
Laennec (1811) described the tuberculous lesion from the anato- 
mical and pathological standpoint. Giirlt pointed out for the first 
time in 1831 the similarity, the identity in fact, of tuberculous lesions 
in man and the ox. 

In 1865 Yillemin showed that tuberculosis could be conveyed 
from animal to animal, always producing similar lesions, and in 
1868 Chauveau proved that, in the calf, infection might arise simply 
from the eating of tuberculous material. 

At a somewhat later date doubts were entertained regarding the 
identity of human and bovine tuberculosis. Virchow denied the 
identity of the two diseases on the basis of a comparative study of 
the lesions. His opinion, however, has not prevailed, and the doctrine 



TUBERCULOST?^. 68?) 

of the identity of tuberculosis in mammals still appears probable, in 
spite of the recent declarations of Koch (1901). 

Causation. Tuberculosis is due solely to the activity of the 
tubercle bacillus. In 1884 Koch isolated and cultivated this bacillus 
in living animals, and always reproduced typical tuberculous lesions 
by injecting cultures. In 1887 Nocard and Eoux described a rapid 
method of cultivating the bacillus, and in 1890 Koch announced the 
discovery of tuberculin. 

The tubercle bacillus assumes the form of a little rod, five or six 
micro-millimetres in length, and '03 to '05 fx in thickness. It has a 
special staining reaction when treated with Ehrlich's or Ziehl's 
solution. It grows between 98° and 104° Fahr. (37° and 40° C.) in 
various artificial media containing glycerine. 

Healthy subjects become infected by the accidental entrance of 
germs into their bodies, either by the respiratory and digestive tracts, 
or through solutions of continuity in the skin. 

The material from tuberculous centres is virulent, whether con- 
sisting of sputum or discharge, saliva, faeces, urine, milk, etc., or 
tuberculous tissues derived from the different viscera. 

The blood and muscular tissues are not always virulent, even in 
cases of generalised tuberculosis. 

The virulent organisms usually enter the body through the lym- 
phatic system; invasion proceeds from the point inoculated towards the 
nearest lymphatic glands and thence along the chain of lymphatic 
vessels, and the lesions extend, attacking the internal organs inore 
or less rapidly. The body does not necessarily become fatally in- 
fected as a consequence of accidental or even experimental infection, 
for the bacillus may itself be destroyed by the phagocytes, or the 
lesion may remain purely local. 

Although tuberculosis is the gravest and most widespread disease 
on the surface of the globe, its contagious character is relatively little 
marked, a fact which has unfortunately led to its receiving little 
attention in ordinary life. 

Contagion is usually the result of cohabitation, although contact 
between diseased and healthy subjects for a period of some days or 
even weeks does not seem sufficient to produce the disease. Nocard 
has fixed a mean period of five to six months as necessary for the 
contraction of the disease by bovine animals, and Moussu has arrived 
at almost identical results by placing tuberculous and healthy cows 
together in a byre reserved for such researches. In this connection, 
however, very great differences of individual susceptibility exist, and 
these are difficult to appreciate in the present state of our knowledge. 
It thus happens that an animal of vigorous appearance and in good 



684 Infectious diseases. 

condition may easily contract tuberculosis, whilst a thinner and less 
vigorous one will resist it for a comparatively long time. 

Speaking generally, it may be said that young animals contract 
tuberculosis by cohabitation in infected places more easily than adult 
or aged ones, and the fact that old animals contribute the larger 
number of cases is to some extent due to their having in the course 
of their lives been more exposed to continued or successive infection. 

Contagion does not occur in byres unless as the result of the 
presence of animals with open tuberculous lesions, such as caverns 
in the lungs, tuberculous bronchitis wdth ulceration of the mucous 
membrane, tuberculous metritis, enteritis, etc. The virulent germs 
are expelled in the saliva, nasal discharge, excrement, etc., and are 
distributed over the forage, manure, litter, and in the drinking water ; 
after desiccation they may be spread by currents of air. 

The mangers, racks, drinking pails, and various stable utensils 
become permanently contaminated, the air of the cow-sheds contains 
virulent dust, and the animals there confined are continually exposed 
to infection either through the respiratory or digestive passages. 

Contamination through the respiratory tract is by far the most 
frequent cause of the evil, and recent experiments at Pouilly-le-Fort 
(1900) have shown how easy it is to convey the disease experimen- 
tally by inhalation. 

Patients suffering from closed tuberculous lesions of the pleura, 
pericardium, spleen, peritoneum, etc., do not spread the bacilli. 
Healthy animals may remain in contact with them without danger, 
but it is well to remember that such cases are quite exceptional. 
As a rule the lesions are of a mixed character, and the general 
principle may be laid down that cohabitation of any duration with 
tuberculous subjects is dangerous. 

Contagion spreads more easily, in proportion to the number of 
tuberculous subjects in a given byre, to the total number of 
animals in a herd, and to the neglect of cleanliness, good feeding, 
ventilation, etc. 

Life in the open air and at grass greatly diminishes the chances 
of contagion. The virulent products are then disseminated in all 
directions and are soon destroyed by the general atmospheric con- 
ditions. Close confinement in ill-ventilated stables, on the contrary, 
strongly tends to the propagation and development of tuberculosis. 

In calves infection may occur through the alimentary tract by 
means of tuberculous milk, whether such milk is obtained directly 
from the udder or out of a pail. The same may be true of young 
pigs fed with skimmed milk. 

Goats contract tuberculosis somewhat readily by confinement in 



TUBERCULOSIS. 685 

byres with tuberculous cows, and Moussu declares that contagion 
afterwards spreads just as rapidly among goats as among cows. The 
vaunted great resistance of goats to tuberculosis, formerly so often 
spoken of, and by some wrongly considered as a condition of immunity, 
is deceptive, and if tuberculosis is less frequently seen in goats, this is 
solely because goats enjoy the greatest liberty at all seasons. 

On the other hand, the disease is very rarely conveyed to sheep, 
even when they are kept for long periods with tuberculous cows. 
Moussu found that two years of close cohabitation were necessary 
for its development under these conditions. 

Heredity is a factor of the highest importance in determining the 
causation of tuberculosis. At the present time a tendency exists to 
deny this, but such a view is erroneous. 

Observation has clearly shown that tuberculosis is rarely con- 
veyed from the mother to the foetus, and that practically none of 
the calves borne by tuberculous mothers react to tuberculin (95 per 
cent. : Nocard and Bang) ; but even if this is absolutely correct, it 
only show^s that great benefits might be derived if proper sanitary 
organisation and intelligent hygienic conditions in byres were found 
everywhere in the country. Unfortunately in practice this is far 
from being the case. These non-tuberculous calves are left in com- 
mon contaminated byres, where they rapidly become infected and 
perpetuate the disease. 

Physiologically these facts are easily explained. The placenta 
resists the passage of microbes, or at least only allows them to pass 
under quite exceptional conditions, and practically only when the 
blood-vessels are affected. As, on the other hand, tuberculosis of 
the ovaries, Fallopian tubes or uterus generally prevents pregnancy 
and causes sterility, there is nothing extraordinary in the fact that 
tuberculosis is not hereditary in the strict sense of the term. The 
influence of the sire has been invoked, but it has been proved that 
direct paternal infection is only possible where ulcerating tuberculous 
lesions of the testicle, prostate, or vesiculse seminales exist. Such 
conditions seldom or never occur in the sires of domestic animals. 
As a general rule, therefore, it may be said that tuberculosis is 
not hereditary. New-born animals become infected during the months 
following birth, either directly through the alimentary tract when the 
mothers are suffering from mammary tuberculosis, or, perhaps more 
frequently, through the respiratory and digestive tracts. 

But although microbic infection is not hereditary, it by no means 
follows that the offspring of tuberculous subjects are as well prepared 
for the struggle of life as the descendants of healthy subjects. What 
is transmitted is a greater tendency to contract the disease. 



686 INFECTIOUS DISEASES. 

This aptitude or predisposition is of such importance that in 
Moussu's opinion it should be regarded as one of the essential factors 
in the development of tuberculosis. The cause of tuberculosis is 
Koch's bacillus. It does not always produce its full effects in animals 
born of healthy parents ; but in one that suffers from a tuberculous 
hereditary taint tuberculosis appears. 

Physiological and pathological researches cast considerable light 
on this question. In tuberculous mothers the organism not only 
suffers from the infection, but from a permanent intoxication which 
interferes with normal metabolism in the vital organs and the ex- 
changes between mother and foetus. If the microbes remain confined 
to the system of the mother, their poisons are conveyed by the blood 
and pass through the placental barrier. In a greater or less degree 
they saturate the tissues of the little creature in process of develop- 
ment, and communicate to it a peculiar hereditary taint. The effects of 
this taint are often noticeable from the moment of birth, for com- 
parative physiological and pathological investigations have shown that 
the tissues of tuberculous animals assimilate given foods less perfectly 
and are the seat of greater losses of all kinds than those of healthy 
subjects. 

Although the disease itself, therefore, is not hereditary, it is other- 
wise with the organic taint which plays so important a part in its de- 
velopment. This organic taint consists in a special condition of the 
tissues or cells of the parents, which show a diminished power of 
resistance to the action of the germs of tuberculosis ; it is therefore 
easy to understand how important a part these influences may play 
under certain conditions. 

Without doubt, in the case of bovine animals, the predisposition 
could be neutralised in carefully managed studs by the immediate 
isolation of the new-born under conditions which shield them from 
tuberculous infection, and experiment has shown the benefits derived 
from such precautions ; but it must not be forgotten that intelligently 
managed studs are the exception, and that for a long time to come 
we must in practice take cognisance of the actual conditions under 
which the disease develops. 

The lesions of tuberculosis vary greatly in appearance, according 
to the organs affected, though the method of development is always 
identical. 

The primary lesion corresponds to what has been termed tuber- 
culous granulation, or anatomical tubercle properly so called ; this, 
the macroscopical, pathological entity, assumes the form of a small 
prominent centre, semi-transparent, greyish, opaque or yellowish, ac- 
cording to its age. 



TUBEECULOSIS. .687 

These tubercles, produced by the presence of colonies of bacilli, 
are due to the defensive reaction of the invaded tissues, which gradu- 
ally undergo change and are destroyed in a direction radiating from 
the centre towards the periphery. The tubercle in itself has no very 
specific character — only the bacillus. 

The elementary lesion may remain isolated, but very frequently 
it is closely surrounded by other similar tubercles, and becomes 
enveloped in a common inflammatory area. A large portion of an 
organ may appear as if riddled with tubercles of different age and 
size, while the interstitial connective tissue reacts and forms fibrous 
separating partitions. The general appearance is that described under 
the term ''diffuse tuberculous infiltration." 

At a still more advanced stage in the development of the disease 
conglomerations are produced, consisting of tuberculous masses the 
size of a hazel-nut, a walnut, an egg, a man's fist, or even larger. 
These lesions, irrespective of size, undergo caseous degeneration from 
the centre towards the periphery. 

In exceptional cases the tubercles remain fibrous. More frequently, 
particularly in animals of the bovine species, they become infiltrated 
with lime salts. Caseous degeneration not only invades the centre of 
the tubercles but also the peripheral layers, and sometimes the whole 
of a conglomerated mass. 

Steadily pursuing their course of pathological development, the 
tuberculous masses become softened and are transformed into tuber- 
culous abscesses, which open towards any free passage, leaving behind 
sometimes ulcerations, sometimes caverns of varying sizes, or blind 
simple or bifurcated fistulse. 

Kecent experiments by Nocard and Eossignol (1900) prove con- 
clusively that a certain time (always more than a fortnight) elapses 
between the moment of entry of the contagion into the organism 
and that at which its eft'ects become manifest by furnishing a 
reaction to tuberculin. Calcification or softening of the lesions, 
moreover, never occurs in less than fifty days. 

According to the organs studied, these tuberculous lesions assume 
certain appearances, which in each locality seem almost always to be 
identical. 

Thus, as regards the larynx, trachea, and bronchi, the tubercles 
develop in the depths of the mucous membrane, rapidly undergoing 
caseous transformation, softening and purulent degeneration, and pro- 
ducing numerous isolated or confluent ulcerations in the air passages. 

According to the case and the kind of animal affected, the lung 
presents either disseminated tuberculous formation, tuberculous in- 
filtration, tuberculous conglomeration, or cavern formation. 



688 INFECTIOUS DISEASES. 

The lung may be affected to such a degree that it appears incredible 
that the blood can have been sufficiently aerated to support life. 

The lungs may be transformed into yellowish, caseous, calcareous, or 
softened masses enveloped in thick, fibrous, resistant walls. The inter- 
vening pulmonary tissue may be healthy in appearance, or reddened, 
congested, and sometimes hepatised. 

The pleural, pericardial, and peritoneal membranes may be covered 
with exuberant tuberculous lesions, like ripe mulberries, in consequence 
of fusion and massing of the tuberculous growths. The primary 
tubercles are surrounded with fibrous walls, which granulate when 
on the surface of a serous membrane, and impart to the membrane a 
vegetative, sometimes villous appearance, and a colour varying from 
pink to light or dark red. 

The collective lesions lining the cavities are described by butchers 
under the significant term of " grapes." In the interior of these exu- 
berant masses, which sometimes form layers an inch or more in thick- 
ness, the tuberculous lesions undergo the usual developmental changes, 
that is to say, they become caseated or infiltrated with lime salts, but 
they do not so readily undergo softening as those of the lung. The 
parietal and visceral serous membranes readily become" adherent at 
numerous points, setting up union between the lung and the walls of 
the chest, or the intestine and the walls of the abdomen, etc. 

In the pericardium the vegetations are frequently of a fungoid 
character. 

Tuberculosis of lymphatic glands sometimes assumes a disseminated, 
discrete form or that of a diffuse infiltration, or, again, in old-standing 
cases it constitutes a massive tuberculous conglomeration. In point 
of fact, the lymphatic glands as such no longer exist, their tissue 
having undergone total degeneration ; they are represented only by 
an enlarged, thick, fibrous shell, forming the envelope which encloses 
caseated and calcareous masses of a more or less soft nature. 

Tuberculous infiltration of the sub-maxillary and sub-parotideal lym- 
phatic glands interferes with swallowing and breathing, compresses the 
pharynx, oesophagus and larynx, and deforms the head. 

Compression of the arteries, veins, nerves, etc., at the entrance to 
the chest may cause various symptoms which are not difficult to inter- 
pret. The glands at the entrance to the chest and the whole of the 
anterior mediastinum may form a single mass. Lesions in the pos- 
terior mediastinum, how^ever, are of even greater importance and 
explain certain symptoms, such as difficulty in swallowing, spasm 
of the oesophagus, mechanical contraction of the oesophagus, perma- 
nent tympanites, etc., for which the state of the lungs alone would 
not account. 



WbErculosiS. 689 

Even when the lungs are unaffected it may happen that the lym- 
phatic glands of the mediastinum (superior or inferior oesophageal 
lymphatic glands) and the bronchial lymphatic glands may be so 
diseased that the oesophagus is completely surrounded and compressed 
by them, and its function thus seriously impaired (Fig. 276). 

In the abdomen the mesenteric glands are most exposed to disease, 
and when infected through the intestinal tract they assume the form 
of large flattened masses arranged along the mesentery. 

In the digestive tract, as in the trachea and bronchi, tuberculosis 
has a marked tendency to assume the ulcerative form. Disseminated 
or aggregated tubercles develop in the thickness of the mucous mem- 
brane, and, after rapidly softening, become ulcerated. The nature of 




'\ 

-Tuberculosis of lymphatics. PG, Left lung ; PD, right luiig ; TT, 
tuberculous oesophageal lymph glands; A, aorta; (E, oesophagus (the lung 
is divided transversely near its centre). 

these lesions can only be determined by noting their character and 
examining the discharge. 

The ulcerations are localised in the mouth and pharynx, in the second 
half of the small intestine towards the ileum, and in Peyer's patches. 

Tuberculous lesions develop in the vaginal sheath of the male genital 
organs exactly in the same way as in an ordinary closed serous cavity ; 
tubercles may also develop on the surface or in the substance of the 
testicle. They become aggregated, undergo softening, spread towards 
the interior, and may break down, thus forming abscesses. In the 
female genital passages the disease invades the thickness of the walls, 
but shows a marked tendency to ulceration, as in the intestine or 
trachea. 

In the udder tuberculosis is generally diffuse, shows a tendency 
to hypertrophy and the free formation of fibrous or sclerous tissue ; 
only tubercles in the glandular layer of the acini become ulcerated. 
In time the whole of the secreting structure undergoes diffuse tuber- 
culous suppuration, fibro-caseous masses form in the depths of the tissue 
and may soften, producing deep-seated tuberculous '' cold abscesses." 
D.c. Y y 



690 INFECTIOUS DISEASES. 

The mammary lymphatic glands are affected in the same way as other 
lymphatic glands. 

In the joints tubercles appear either on the synovial membrane or 
in the thickness of the bony epiphyses, very often at both points simul- 
taneously. The synovial membrane is covered with vegetations and 
villous growths, the ends of the bones are attacked by a destructive 
ostitis, tubercles or tuberculous centres form in the thickness of the 
spongy tissue, the articular cartilages are destroyed, the ends of the 
bones become deformed, and in the last stages fungoid arthritis in 
various forms may be produced. 

In bones the tubercles originate in the depths of the spongy tissue. 
They produce destructive hypertrophic ostitis, in which the bony tissue 
is replaced by tuberculous centres or masses divided by fibrous parti- 
tions. On section, these lesions exhibit the same yellowish caseated 
or calcified appearance as the lesions of other affected organs. The 
compact layer may sometimes be perforated at several points before 
being destroyed. 

In tuberculosis of the brain the primary lesions develop at the 
expense of the serous layers of the arachnoid and on the pia-mater, 
towards the base of the brain and the fissure of Sylvius, or at the 
expense of the small vessels which penetrate the depths of the nerve 
substance itself. Some tubercles remain isolated, become confluent or 
are collected in masses of different sizes, and provoke symptoms which 
vary with the locality attacked. 

Symptoms. Tuberculosis is the most protean of all diseases, and 
at first sight it often seems impossible to assign to one group, clinical 
conditions presenting such essentially different appearances. All the 
tissues may be attacked, from the bones to the most delicate of the 
viscera, a fact which explains why all aspects of tuberculosis cannot 
be described. Certain forms, however, occur very frequently, and 
may be regarded as classic ; these will be considered in the order of 
their frequency. 

TUBERCULOSIS OF THE RESPIRATORY APPARATUS. 

Without doubt this form of tuberculosis is by far the most fre- 
quent. It assumes the form either of bronchitis, laryngo-bronchitis, 
or pulmonary tuberculosis. 

Tuberculous Bronchitis. — The symptoms of tuberculous bronchitis 
do not essentially differ from those of ordinary bronchitis, though the 
disease develops more insidiously and slowly, and is seldom accom- 
panied by fever. At first the cough is dry and suppressed ; later it 
becomes paroxysmal, and at a still more advanced period liquid and 



TUBERCULOSIS OF THE KRSPIRATORV APPARATUS. 601 

rough. The least irritation brings on these attacks of coughing ; 
changes from the warmth of the stable to the coldness of the outer 
air or vice versa, the presence of dust or the action of liquids when 
drinking, etc., etc. During the first stage coughing is not followed 
by expectoration, but later yellowish-grey, glairy mucus may be dis- 
charged : more frequently it is coughed into the pharynx and swallowed. 

These symptoms continue for weeks or months without showing 
any tendency to abate. If the larynx is attacked inspiration becomes 
rattling and difficult, while the neck and head are held extended, and 
the least pressure over the larynx produces coughing. 

Tuberculosis of the larynx, trachea, and bronchi is usually accom- 
panied by disease of the lung, but may occur by itself. 

When there is a discharge it consists of thick, viscous, sticky 
mucus of a peculiar greyish-yellow colour. Microscopical examination 
shows it to contain tuberculous bacilli. 

Pulmonary Tuberculosis usually assumes the chronic form, and is 
almost always preceded by specific bronchitis. The patients retain 
their appearance and condition for a longer or shorter time, and, 
without the experience resulting from continued observation, it would 
be difficult to believe them to be suffering from the slow development 
of a serious disease. 

Frequent coughing without any apparent reason is the only symptom 
likely to arouse suspicion. 

At a later stage these animals lose condition, feed less eagerly or 
exhibit capricious appetite, and sometimes well-marked and repeated 
digestive disturbance, such as slight tympanites with constipation or 
diarrhoea, moderate impaction of the rumen, relative atony and 
slackening of peristaltic movements. The wasting gradually becomes 
more marked or, in the case of pregnant or milch cows, makes 
intermittent progress, until the animals become anaemic and finally 
cachectic. The cough is more frequent and more severe, and is 
followed by discharge from the nose or by swallowing movements. 
From this time phthisis, properly so called, exists. 

The course of the disease is not invariable. Certain animals may 
appear ill for years without clinically showing the least apparent 
aggravation ; others on the contrary, though living under similar 
conditions, are rapidly attacked, and in six to twelve months exhibit 
all the signs of advanced phthisis. Pregnancy, suckling, and pro- 
longed lactation favour the development of the disease by taxing 
the physical resources of the animal. 

Animals suffering from phthisis exhibit a peculiar appearance. 
They are extremely thin, all their soft tissues are wasted, the limbs 
are dragged in moving, respiration is rapid and sometimes jerky, 

Y Y 2 



692 INFECTIOUS DISEASES. 

the mucous membranes are pale and discoloured, and the skin is 
tight and adherent to the subjacent tissues. 

These general signs, however, would not warrant a diagnosis, for, 
apart from the cough, certain other diseases present all the external 
appearances of the last period of tuberculosis (chronic diarrhoea, 
chronic forms of poisoning — bacterial or otherwise — dyspepsia, etc.). 

In cases of doubt it is essential to discover by percussion and 
auscultation that the external signs are really the result of lesions 
of the lung, and that the lung disease has developed gradually in 
accordance with the signs shown by simple external inspection. 

The symptoms presented during the development of the pulmonary 
lesions may be divided into three phases. 

In the first phase percussion gives no information, though auscul- 
tation reveals rough respiration, inspiration and expiration being 
also unequal. Expiration, which, in the healthy subject, is silent, 
becomes clearly perceptible, not over the whole lung, but usually over 
the anterior lobes, particularly the cardiac lobes. This sign is the 
result of tuberculous infiltration and of the neighbouring pulmonary 
tissue having lost its elasticity. 

Inspiration is rough and rasping, and sometimes occurs in several 
stages, the act being interrupted or jerky ; expiration lasts longer 
than inspiration, is rough and prolonged, but never blowing in 
character. These peculiarities are only found in one other condition 
of the lung, viz., emphysema. 

The patients appear little affected in this, the first, stage of tuber- 
culosis. But for the cough they may seem perfectly healthy. 

In the second phase the tuberculous infiltration extends and ends 
in the massing, by fusion or centrifugal growth, of the tuberculous 
masses. 

Percussion may now indicate localised dulness, but this is not 
invariable, because the diseased anterior and middle lobes of the 
lung are concealed beneath the muscles of the shoulder. When 
dulness is noted, it is usually over the low^er part of the posterior 
lobes, very rarely at any higher point on the side of the chest. 
Frequently the dulness is only partial. 

On auscultation the signs met with during the first stage become 
much more marked. Inspiration is always rough, rasping, painful 
and difficult at certain points, particularly in the anterior zones. 
In this region expiration is rough, prolonged and sometimes of a 
clearly marked blowing character. This is particularly the case in 
the sub-scapular zone and the auscultation zones 2 and 3 (Fig. 166). 
In the dorsal region and in zone No. 1, respiration may appear 
normal. Nevertheless, the sounds are propagated to a distance, the 



TUBERCULOSIS OF THE RESPIRATORY APPARATUS. 693 

infiltrated lung steadily loses its elastic qualities, the vesicular murmur 
entirely disappears from the affected regions, and the sounds noted are 
of bronchial origin. 

Like the first, the second phase may vary in intensity, extent, 
and in the diffusion or localisation of the tuberculous lesions. 
Blowing respiration may be noted over different areas, accompanied 
by sibilant, snoring and migratory mucous rales. The vesicular 
murmur is exaggerated in the healthy parts, coughing, accompanied 
by expectoration or followed by swallowing movements, is frequent, 
the appetite becomes capricious, and the general condition suffers. 
In this second phase almost the whole of one lung may be diseased 
and exhibit the signs described. 

The third phase corresponds to the softening of the tuberculous 
masses, and the formation of ulcers and caverns. The zones of 
dulness or partial dulness may be more extensive, though cavern 
formation is usually confined to the anterior or middle lobes. Per- 
cussion still affords no precise information. 

As the tuberculous masses undergo softening and ulceration, 
their contents are gradually passed into the bronchi, and ausculta- 
tion reveals signs indicative of the existence of caverns, which signs 
vary with the dimensions of the caverns themselves. On ausculta- 
tion the respiration is always found to have at certain points a 
blowing character, and it may even develop into a true tubal souf&e. 
In other areas, where the caverns are merely in course of formation, 
gurgling sounds are all that are heard, but where true caverns 
exist there is an incessant cavernous souffle. 

The lesions peculiar to the third phase are seldom seen in prac- 
tice ; because the animals become anaemic, exhausted and cachectic, 
they are usually slaughtered early. Nevertheless, the third stage occa- 
sionally develops in an astonishingly short time, six to eight months 
at most. 

Very frequently the patients, although cachectic and even phthisical, 
do not yield on auscultation the sounds described as peculiar to the 
third stage, because the tendency to softening is not very marked in 
bovine animals. The lungs exhibit massive infiltration, and, whilst 
pulmonary consumption is not uncommon, the development of caverns 
is comparatively rare. 

The expectoration or discharge in this third form is puriform, 
glairy, viscous, and of a dirty-yellow or even greenish-yellow colour. 
Bacteriological examination reveals the presence of tubercle bacilli 
and adventitious organisms. 

These conditions are always associated with various complications, 
and the second and third stages of chronic tuberculosis are frequently 



694 INFECTIOUS DISEASES. 

accompanied by lesions of the pleura, of the mediastinal lymphatic 
glands, of the liver, etc. 

Digestive disturbances often occur ; the appetite is capricious or 
in abeyance, there is atony of the rumen and chronic dyspeptic 
tympanites. These disturbances are easily understood where there 
are lesions of the liver, intestine, and mesenteric lymphatic glands, 
but not when the lung alone appears the seat of the disease. In 
this condition the patients probably suffer from permanent complex 
intoxication, due to toxins elaborated by the tubercle bacillus and 
other microbes which multiply on or in the lesions, and this chronic 
intoxication reacts on the vital functions (innervation, secretion, 
digestion and nutrition). Nor are the effects limited to these appear- 
ances ; the heart's action is also accelerated, and the temperature 
rises. During the first and part of the second phase there is com- 
paratively little fever, but afterwards this is continuous or of a 
peculiar intermittent character. In the morning the patient's 
temperature may be normal ; in the evening it has risen from 
1*5 to as much as 9^ Fahr. (1'1° to 5'2^ C.) above normal, and 
this recurs day by day. These attacks coincide with softening of the 
lesions, and when suppurating caverns exist they are more marked 
and more nearly continuous, assuming the characters of the hectic 
fever shown in consumption. 

Often during the febrile periods the urine is albuminous. 

In chronic tuberculosis of bovine animals bleeding from the lung 
is rare even when caverns exist, and Moussu, in spite of extensive 
experience, has seen only two cases. This is in striking contrast with 
the condition in human sufferers from pulmonary tuberculosis, two- 
thirds of whom bleed at the lungs. 



TUBERCULOSIS OF SEROUS MEMBRANES. 

After pulmonary tuberculosis, tuberculosis of the pleural and peri- 
toneal serous membranes is the most frequent clinical form of this 
disease. Sometimes both forms exist, and although the pleural and 
peritoneal lesions predominate or alone attract attention, there are 
also lesions in the lung or mediastinal lymphatic glands. 

It is ditjicult to explain how the pleural and peritoneal serous 
membranes can be seriously invaded without the lung becoming 
affected, though in point of fact such a state of things frequently 
exists. 

Tuberculosis of the pleura without pulmonary lesions is suggested 
by very obscure symptoms. The general signs consist in diminution 
of appetite, loss of condition, tachycardia, elevation of temperature, 



TUBERCULOSIS OF SEROUS MEMBRANES. 695 

and progressive organic wasting. These are always present, though 
in themselves they have no specific significance. 

The local symptoms are still more vague. Percussion causes pain, 
and the practitioner might at first suspect peri-pneumonia. The 
patient edges aw^ay, and tries to avoid the application of the plexi- 
meter hammer. Firm pressure over the intercostal spaces sometimes 
causes struggling, and produces indications of abnormal sensitiveness. 
There is generally extensive partial dulness, sometimes complete dul- 
ness towards the low^er regions of the chest. 

On auscultation the lung may reveal the difierent indications of 
chronic pulmonary tuberculosis, or simply diminution of the respira- 
tory murmur at points, accompanied by crepitant, sibilant rales, and 
moist, crackling sounds. As the -anterior portions of the pleural sacs 
are most commonly invaded, the anterior vena cava is compressed, 
causing some difiiculty in the return circulation, and producing venous 
pulse, which may extend as high as the parotid gland; there is, how- 
ever, no swelling of the dewlap. 

Respiration is frequent and difficult in consequence of adhesions 
between the pleura and lungs, which are connected by bands of 
fibrous tissue of varying extent. Coughing is rarely absent, and if the 
lung is diseased may be followed by discharge containing numerous 
bacilli. Otherwise the cough exhibits the pleuritic character, that 
is, it remains slight, dry, paroxysmal, and painful. The pericar- 
dium may be affected as well as the pleura; if the conditions occur 
simultaneously the venous pulse in the jugulars will be particularly 
apparent. 

The symptoms of tuberculous pericarditis are similar to those of 
ordinary pericarditis, except that the exudation is less abundant ; in 
a word, the symptoms are those of rather trifling exudative peri- 
carditis. 

Tuberculosis of the peritoneum is frequently accompanied by that 
of the pleura or the abdominal viscera. The lesions are localised on 
the parietal peritoneum and epiploon, producing in time adhesions 
between the viscera and walls of the peritoneal cavity, w^hich affect 
the action of the digestive organs, gradually causing interference with 
the peristaltic movement both of the rumen and the intestines. The 
stagnation of alimentary matter favours fermentation, so that the 
ramen becomes permanently distended. The right flank also is 
swollen, and the abdomen exhibits a change in shape similar to that 
in peritonism, which is a constant symptom of tuberculous peritonitis. 

As in the thorax, the tuberculous lesions seldom produce extensive 
liquid exudation, so that ascites does not occur, but on palpation 
the abdoniinal walls appear to have entirely lost their pliability and 



696 INFECTIOUS DISEASES. 

to be unyielding and greatly thickened, a point which is the more 
remarkable as the animals are thinner. 

The wall of the abdomen is stiff, incapable of being depressed as 
in ordinary subjects, and gives to the fingers the sensation of a thick 
hard covering, through which the subjacent organs and their contents, 
that is, the rumen, intestine and alimentary material, can no longer 
be felt. This rigidity is always most marked in the lower abdominal 
region. The digestive peristaltic movement can no longer be detected, 
and on auscultation the normal sounds are manifestly much slower 
than usual. 

TUBEECULOSIS OF LYMPHATIC GLANDS. 

It might perhaps have seemed more logical to place tuberculosis of 
the lymphatic glands at the commencement of these clinical divisions 
of tuberculosis, as when tuberculous lesions, of whatever kind, occur 
in the lung, pleura, abdomen, etc., the lymphatic glands in the neigh- 
bourhood are invariably invaded. In such cases, however, the lesions 
in question are not the dominant features. 

Under this heading must be classed tuberculous lesions which, on 
the contrary, affect the lymphatic glands in so marked a manner that 
lesions in other organs m^ay be regarded as secondary. This occurs 
somewhat frequently, because at the present day there is a tendency 
to believe that inoculation takes place mainly through the mucous 
membrane of the pharynx, and thence extends towards the neighbouring 
lymphatic glands. At any rate, it is unquestionable that tuberculosis 
of the lymphatic glands may exist quite apart from any other lesion 
visible to the naked eye. 

Two forms are very common, tuberculosis of the retro-pharyngeal 
region and of the neck, and tuberculosis of the mediastinal lymphatic 
glands. 

Tuberculosis of the Retro-pharyngeal Glands. — In addition to 
the retro-pharyngeal glands the cervical chain of lymphatic glands, 
the sub-glossal, sub-atloid, pre-parotid, and even the pre-scapular 
lymphatic glands and those at the entrance to the chest, may also 
be invaded more or less. 

This form of tuberculosis may remain latent for a long time, atten- 
tion being attracted to it only when deglutition is impeded and local 
deformity becomes apparent. 

Swelling of lymphatic glands resulting from tuberculous infection 
is slow and progressive, differing entirely from that which accom- 
panies suppurative adenitis. The neighbouring connective tissue is 
certainly somewhat thickened or infiltrated, but the glands themselves 
can always be detected. The region of the gullet is enlarged, the 



TUBERCULOSIS OF LYMPHATIC GLANDS. 



•697 



upper 



depression marginating the lower jaw is filled up, the sub-atloid space 
disappears, the sub-glossal glands occupy the space beneath the tongue, 
and in cases where the lesions are very pronounced the oesophagus 
and larynx may even be pushed downwards. 

Swallowing is difficult, in consequence of compression of the 
part of the oesophagus, and, as the 
laryngeal nerves may be included in 
the swelling, dyspnoea or roaring not 
uncommonly results. 

By palpation with one or both 
hands, it is easy to identify the glands 
and detect enlargement, hardness and 
sensitiveness. In exceptional instances 
the caseous masses they contain 
undergo softening and conversion into 
purulent material. 

When the cervical lymphatic glands 
are attacked the jugular furrows dis- 
appear, and the whole of the pre- 
tracheal and lateral regions of the 
neck exhibit doughy swellings. 

These swellings are rarely sym- 
metrical, a fact which admits of this 
condition being distinguished from 
lesions due to lymphadenitis, without 
examining the blood. 

The prescapular glands are rarely 
attacked, but those at the entrance 
to the chest, which may be found on 
either side of the trachea by passing 
the fingers between the two first ribs, 
are frequently enlarged to the size of 
a fowl's egg. 

Tuberculosis of the Mediastinum. 
— Whenever the lungs are much in- 
volved, the bronchial glands are also 

invaded, though the glands of the anterior and posterior mediastina 
may escape. On the other hand, the mediastinal glands are some- 
times much involved, whilst the lung remains intact. 

The lymphatic glands, particularly those of the mediastinum, may 
be enormously enlarged, and the various accidents which result are 
due as much to mechanical interference with the functions of adjacent 
orajans as to the lesions themselves. 




^^ 



Fig. 277. — Lesions in retro-pharyn- 
geal tuberculosis. T, Trachea ; 
(E, oesophagus ; P, pharynx ; 
H, hyoid bone ; E, epiglottis ; 
L, tongue ; G, tuberculous retro- 
pharyngeal glands. 



698 



INFECTIOUS DISEASES. 



When the glands of the anterior mediastinum are affected, they 
cause compression of the anterior vena cava, with stasis of blood in 
the jugular vein and venous pulse, then compression of the oesophagus 
and trachea, and of the nerves at the entrance to the chest, producing 
difficulty in swallowing, respiration and circulation. 

If, as often happens, the glands of the posterior mediastinum are 




Fig. 278. — Well-developed tuberculosis of the mediastinal lymphatic glands. 
PG, Left lung; PD, right lung; CE, oesophagus; A, posterior aorta; T, 
tuberculous lymphatic glands. 



affected and greatly enlarged, they may involve the oesophagus and 
the oesophageal nerves, interfere with deglutition and rumination, and 
thus produce marked disturbance. The animals only swallow with 
difficulty, and later rumination becomes impossible, the anti-peristaltic 
movement not being powerful enough to overcome the resistance. 
Soon after eating, the patients exhibit tympanites, certainly only to 
a moderate extent, but the swelling is long in disappearing. This 



TUBERCULOSIS OF THE DIGESTIVP: TRACT. 699 

tympanites is due to the difficult}^ in eructation and to the impossi- 
bility of rumination. The contents of the rumen pass slowly towards 
the intestine until the onset of a fresh attack. 

On account of digestive difficulties, the animals rapidly lose flesh, 
just as though they were suffering from extensive visceral lesions. 



TUBERCULOSIS OF THE DIGESTIVE TRACT. 

Tuberculosis of the digestive tract is rarer than tuberculosis of 
the lungs or lymphatic glands, and occurs in two well-differentiated 
clinical forms, that is to sa}^, tuberculosis of the buccal and pharyngeal 
membrane and tuberculosis of the intestines. Tuberculosis of the liver, 
which is less easily recognised, is indicated by signs of dyspepsia. 

Bucco-Pharyngeal Tuberculosis. — This may be primary or secon- 
dary, and occurs in the form of local or general glossitis or superficial 
ulcerative stomatitis. 

In the former case the glossitis may be regarded as due to actino- 
mycosis ; in the latter it can only be mistaken for simple ulcerative 
stomatitis. 

It is accompanied by difficulty in mastication, and still more, W'here 
the pharynx is invaded, in deglutition ; abundant frothy salivation in 
feeding; sometimes by true spasm of the pharynx and rejection of 
masticated balls of food. 

Locally the buccal mucous membrane (cheeks, tongue, pillars of 
the fauces, etc.) exhibit ulcerations, with festooned borders, in size 
something between a florin and a five-shilling piece, covered with 
a greyish-yellow, earthy-coloured exudation adhering firmly to the sub- 
jacent parts. The margin of the ulceration is but slightly indurated, 
and the tongue preserves its mobility, except in cases of general 
deep-seated glossitis. 

The condition may continue for weeks and months without im- 
provement. 

Intestinal Tuberculosis. — Tuberculous enteritis is always accom- 
panied by tuberculosis of the mesenteric glands and of the sub-lumbar 
lymphatic chain. It is indicated at first by chronic tympanites and 
peritonism, unaccompanied, how^ever, by atony of the rumen ; at a 
later period by intermittent diarrhoea, which attains a maximum and 
is followed b}^ constipation. Finally, when there exist numerous in- 
testinal ulcers, the diarrhoea is profuse and intractable, the animals 
rapidly grow exhausted, and the disease spreads to other organs W'ith 
startling rapidity. 

The food is ill-digested and the faeces have a repulsive odour, as 
has also the gas which escapes from the rumen when it is punctured. 



700 INFECTIOUS DISEASES. 



TUBERCULOSIS OF THE GENITAL ORGANS. 

In males, tuberculosis may attack the testicle and neighbouring 
organs and tissues ; in females, the ovary, uterus, vagina, or udder. 

Tuberculosis of the testicle is rare. Moussu appears only to have 
seen one case, namely, in the boar. The disease produces specific 
vaginitis and specific orchitis, the serous surfaces of the vaginal tunic 
becoming adherent, and tubercles forming in the depths of the tes- 
ticle, whilst in time the testicle becomes the seat of fungoid growths. 

Tuberculosis of neighbouring glands has only been observed in 
the case of the prostate. Clinically it is distinguished by symptoms 
which suggest difficulty in urination, and comprise frequent straining, 
efforts to micturate, dysuria, etc. Examination by the rectum reveals 
changes in the prostate, but affords no exact information as to their 
nature. 

Tuberculosis of the genital tract in the female is usually a delayed 
complication of a preceding visceral tuberculosis, "though it may occur 
as a primary disease, in which case the lesions are localised about 
the vulva or the vagina. Tuberculosis of the ovaries, Fallopian 
tubes, and uterus is much more common than that of the two 
organs just mentioned. It seems certain that the disease may be 
transmitted directly from the male to the female by copulation, in 
cases where the male animal has a lesion on the penis. 

Tuberculosis of the vulva is rarer, and is indicated by swelling, 
sclerotic changes, and the presence of tuberculous nodules, varying in 
size between a lentil and a hazel-nut ; after ulceration of these growths, 
a thick yellowish pus containing the specific bacilli is discharged. 

Tuberculosis of the vagina is also indicated by hardening of the 
walls, sclerous infiltration, and the presence of deep-seated tuber- 
culous nodules, which may or may not become ulcerated. It may 
follow uterine tuberculosis, the discharge from the uterus continu- 
ally soiling and at length infecting the floor of the vagina. In 
such cases the lower wall of the vagina is thickened and infiltrated 
to a greater extent than the roof, and is sometimes intersected by 
transverse ulcerated suppurating folds. Bacteriological examination 
reveals the presence of bacilli. 

Tuberculous invasion of the ovaries. Fallopian tubes, and uterus 
is externally indicated by signs of chronic metritis accompanied by 
a purulent discharge, which may or may not be foetid, but always 
possesses special characteristics. The neck of the uterus is half 
open, and the discharge is continuous. The pus is of a greyish- 
yellow colour, ill-formed, grumous, or more frequently granular, and 
it sometimes accumulates in large quantities in the depressions of 



TUBERCULOSIS OF BONES AND ARTICULATIONS. 



701 





the vagina. Examination by means of the speculum is of great value 
in diagnosing such lesions. On examining the parts through the 
rectum, the walls of the uterus are found to be greatly thickened, 
sometimes indurated, bosselated or totally deformed. 

The Fallopian tubes and ovaries may have attained enormous 
dimensions, and the normal anatomy of the parts is greatly altered 
both as regards dimensions and relations. 

The almost inevitable consequences of tuberculosis of the genital 
organs are hypertrophy^ induration or caseation of the subsacral 
and sublumbar lym- 
phatic glands. 

Udder. — Tuber- 
culosis of the udder 
may be primary or 
secondary. When 
the infection is slight 
the results may es- 
cape notice for weeks 
or even months, the 
patients appearing y 
to suffer only from 
sub-acute or chronic 
mammitis, while at 
the same time the 
milk preserves its 
ordinary appearance. 
In time, however, 
the mammitis be- 
comes aggravated, the infected regions are enlarged, and the secretion 
becomes grumous, serous, curdled, and of a yellowish colour, after- 
wards ceasing altogether. In some cases one quarter only is attacked, 
though total mammitis is more common. 

These forms of tuberculous mammitis tend towards hypertrophy, 
local hardening, and the formation of deeply-seated cavities contain- 
ing pus, the gland itself sometimes acquiring enormous dimensions. 
The retro-mammary lymphatic glands are invaded even before the 
gland itself is seriously attacked. For a longer or shorter time the 
udder may externally appear healthy, although on manual examina- 
tion these lymphatic glands are found to be indurated and bosselated. 





Fig. 279. — Hj^pertrophic tuberculous mammitis. 



TUBERCULOSIS OF BONES AND ARTICULATIONS. 

Tuberculosis of the bones is seen only in young animals, and 
chiefly affects the vertebral column and the bones of the head. The 



702 



INFECTIOUS DISEASES. 



limb bones are attacked as a rule only in the vicinity of diseased 
articulations. 

The vertebral lesions corresponding to those in Pott's disease in 
human beings are very difficult to discover before they produce com- 
plications, such as depression of the spine, compression of the spinal 
cord, paralysis, etc. 

Lesions of the bones of the head or of the limbs are charac- 
terised by local deformity, destruction of osseus tissue, invasion of 
surrounding tissues, and by local symptoms peculiar to tumours 
originating in the periosteum. 

Tuberculosis of joints produces special symptoms resembling those 
seen in the " white swellings " of man, that is, diffuse, oedematous, 

warm and moderately 
painful swelling of 
adjacent parts, ac- 
companied by lame- 
ness of varying in- 
tensity. According to 
Guillebeau and Hess, 
many conditions de- 
scribed as strain or 
rheumatic arthritis 
are really tuberculous 
in character. They 
may remain station- 
ary for a long time, 
or even recede under 
treatment. As a rule, 
however, these forms 
of tuberculous arthritis assume the fungoid type and prove incurable. 
They are clinically distinguished from ordinary arthritis by the 
enormous swelling, w^hich involves the extremities and a portion of 
the shafts of the bones. The adjacent muscles are chronically con- 
tracted, and the diseased joint is held semi-flexed. In course of time, 
if the patients are kept alive, abscess formation may occur, but this 
is seldom seen in practice, because the animals are slaughtered. 




Fig. 280. 



-Perforating tuberculosis of the 
frontal region. 



'ht 



TUBERCULOSIS OF THE BEAIN. 

Tuberculosis of the nervous centres, localised either in the meninges 
or the brain proper, may attack both yoang and old animals, not as a 
primary condition, but as a sequel to visceral disease, which, however, 
may have produced no outward indications, a fact that renders the 
diagnosis extremely difficult. 



TUBERCULOSIS OF THE SKIN. 703 

When localised in the meninges, the disease produces the symp- 
toms of ordinary meningitis, general weakness, vacillating, stagger- 
ing or irregular gait, disturbed vision, variation in the size of the 
pupils, difficulty in swallowing, muscular twitching, cramp of the 
muscles along the upper margin of the neck, etc. 

Tuberculosis of the brain proper seems more commonly to affect 
the anterior convolutions and the depths of the frontal and temporal 
lobes. It produces some of the symptoms of meningitis or symptoms 
suggestive of the existence of ccenurosis, as, for instance, walking 
in circles, lameness of central origin, without appreciable lesions of 
the limbs, prolonged kneeling, disturbed vision, generaUsed attacks 
of epilepsy or of Jackson's epilepsy, spasm of the pharynx, general 




Fig. 281. — Tuberculosis of the brain. 1, 2 and 3, Tuberculous centres. 

signs of compression of the • brain or cerebral dropsy, dulness, 
coma, etc. 

In the absence of pulmonary lesions it is extremely difficult to 
arrive at an exact diagnosis except after injection- of tuberculin, for 
the above symptoms very closely resemble those of ccenurosis, brain 
tumours, and even tumours in the frontal sinuses. 

TUBERCULOSIS OF THE SKIN. 

Cutaneous tuberculosis is one of the rarest forms of the disease. 
It is distinguished by the formation beneath the skin of little har- 
dened swellings varying in size between a hazel-nut and a walnut, 
and containing caseous or calcareous material. These swellings have 
no connection with the superficial lymphatic glands. They may be 
found grouped together within certain areas, or distributed irregularly 
over the whole body, particularly towards the base of the tail. 

The condition may be mistaken for generalised sarcomatosis, from 



704 iNf^ECTIOUS DiSEASSiS. 

which, however, it is readily distinguished by microscopic examina- 
tion of the contents of the swellings. 

ACUTE TUBERCULOSIS TUBERCULOUS SEPTICEMIA. 

However rapidly the above-described forms of tuberculosis may 
develop, the disease as a whole is always of long duration, and con- 
tinues for months, or even for years. The development of these 
chronic forms may, however, be interrupted by various influences 
which cause it to assume an acute character, either for a time or 
continuously. Each intermittent attack aggravates the condition of 




Fig. 282. — General appearance of a case of cutaneous tuberculosis. 

the patient, but gradually subsides, with or without treatment. Con- 
tinued attacks, however, rapidly lead to death ; they may be seen in 
animals previously unsuspected of any grave disorder. 

The dominant symptom is continuous fever, accompanied by signs 
of disturbance of any or all of the chief bodily functions. 

The temperature rises to 102° Fahr. (39° C), or even to 104° or 
105° Fahr. (40° or 41'' C), with morning and evening remissions of 
some hours. The respiration is accelerated. On auscultation it is 
often difficult to discover signs of chronic tuberculosis. The lung is 
the site of repeated congestive changes, resembling those of broncho- 
pneumonia or contagious pleuro-pneumonia. The pleura and walls of 
the chest become extremely sensitive, as in the last-named disease, 
and the abdomen may exhibit signs of peritonism, as at the begin- 
ning of acute peritonitis. The pulse rises to 80, 90, 100, or even 



TUBERCULOSIS. 705 

120 beats per minute, and the urine contains albumen in notable 
quantities. This condition continues for weeks without apparent di- 
minution, the patients refuse food, lose flesh with startling rapidity, 
and finally die of exhaustion. 

It would be impossible from these peculiarities alone to identify 
the nature of the disease which causes such progressive organic 
wasting, as the continued presence of fever prevents the use of 
tuberculin, but fortunately the preliminary changes in the lungs, 
lymphatic glands, genital tract, etc., are sufficient in most cases for 
the purposes of diagnosis. 

Sheep, Goats, and Pigs. — In the other domestic animals tubercu- 
losis is only of secondary importance to the practitioner. 

It has been seen in the sheep and goat, but almost exclusively as 
the result of experiment. It must be understood, however, that pro- 
longed co-habitation with diseased oxen or lengthened sojourn in con- 
taminated places may easily produce tuberculosis in the goat, though 
the sheep continues to resist for a somewhat longer period. 

Clinically such tuberculosis presents little interest on account of 
its rarity. 

The same remark applies to pigs ; nevertheless, an entire herd 
may become infected, and it may be necessary, after making a pre- 
liminary post-mortem, to examine the other patients. All forms of 
the disease occur in pigs, the lung being most frequently affected, but 
tuberculosis also attacks the intestine, udder, lymphatic glands, joints, 
etc. The pig, in fact, is extremely susceptible to this disease, whilst 
the sheep is only subject to it in a comparatively trifling degree. 

Diagnosis. The clinical manifestations of tuberculosis are so 
numerous and so various that it is often an extremely hard task to 
form a diagnosis. Without doubt detection is relatively easy in well- 
marked forms, such as tuberculosis of the lungs, lymphatic glands 
and genital apparatus, but even in such cases the symptoms must 
be reasonably well-marked. 

At first, unless the lesions produce externally visible signs, diag- 
nosis is impossible, and in the case of hidden forms, such as tuber- 
culosis of the serous membranes, mediastinum, intestine, testicle, etc., 
all that can be done is to take into account the probabilities. 

Clinical diagnosis is therefore possible, but only in exceptional 
cases can it be absolutely relied upon. Fortunately, methods of in- 
vestigation increase and become more exact every day, so that the 
points which clinical examination is incapable of deciding are often 
cleared up in the laboratory. Bacteriological examination of morbid 
products, such as the nasal discharge, the products of suppuration, 
the milk or the diseased tissues, is a valuable means in many cases 

D.C. Z Z 



706 



INFECTIOUS DISEASES. 



^ 



Lci 




~Lc 



of determining the presence of the organism which causes the dis- 
turbance. In all cases, in fact, the tubercle bacillus should be sought 
for in order to confirm the diagnosis. 

If this method cannot be employed, as for example in tubercu- 
losis of the liver, brain, etc., and the diagnosis is uncertain, the use 

of tuberculin constitutes 
^-'~l the surest and easiest 

I I method of coming to a 

conclusion. Nocard's re- 
searches have shown the 
precautions to be ob- 
served. A minimum feb- 
rile re-action of T Fahr. 
(1'5° C.) is, however, 
necessary before the 
existence of the disease 
can be affirmed. 

Lastly, there remains 
a less rapid method, 
which aims at trans- 
mitting the disease to 
specially susceptible 
animals by inoculating 
with suspected materials, 
such as the nasal dis- 
charge, pus, milk or 
pulp of internal organs. 
This method is most 
valuable when bacterio- 
logical examination has 
failed and tuberculin has 
produced only doubtful 
results. The guinea-pig 
is the subject usually 
chosen, but some weeks, 
or even months, may elapse before definite results are obtained. 

In those forms where ordinary methods of investigation prove 
sufficient it is well to bear in mind the symptoms which differentiate 
this disease from others closely resembling it. 

Pulmonary tuberculosis, for example, should always be suspected 
whenever there exists frequent coughing, nasal discharge and poor 
bodily condition ; if in addition to this respiration is found on auscul- 
tation to be rough, inspiration interrupted or rasping, expiration 




Fig. 283. — Tuberculosis of the posterior mediastinal 
lymphatic glands in a sheep which had been 
kept for two years in company with some tuber- 
culous cows. PG, Left lung ; PD, right lung ; 
T, trachea ; La, anterior lobes ; L, middle cardiac 
lobes ; Lj>, posterior lobes ; Gm, tuberculous and 
enlarged posterior mediastinal lymphatic glands. 



TUBEECULOSIS. 707 

prolonged or blowing and the vesicular murmur non-existent, suspicion 
becomes almost a certainty. The diagnosis is even more assured 
if the respiration is of a blowing character at certain points, ac- 
companied by snoring and sibilant rales and gurgling or cavernous 
souffles. 

The distinction between pulmonary tuberculosis and chronic bron- 
chitis or simple pulmonary emphysema is based on the increased 
resonance revealed by percussion in the latter case ; the different 
character of expiration ; the existence of a double breathing move- 
ment ; the external appearance of the animal ; the absence of bacilli 
from the nasal discharge, and the failure to react to tuberculin. 

The condition cannot be mistaken for verminous broncho-pneu- 
monia if the information furnished by auscultation and the results of 
microscopical examination of the discharge are taken into account, 
the eggs or embryos of strongyles being extremely easy to detect. 

Tuberculosis of the pleura may be mistaken for peri-pneumonia if 
the observer trusts to percussion alone, but the auscultation sounds 
are then different, and an injection of tuberculin will remove any 
doubt. 

Tuberculosis of the • peritoneum is often suggested by the indica- 
tions afforded by careful palpation (thickening of the walls of the 
abdomen, rigidity and sensitiveness), and is distinguished from ordi- 
nary acute peritonitis by the difference in the appearance of the 
animals and the absence of much fluid. Chronic exudative perito- 
nitis and ascites also exhibit sufficiently well-marked characteristics 
to enable them to be differentiated from tuberculosis of the peri- 
toneum, but this is certainly not true of adhesive peritonitis, and in 
cases of the latter kind tuberculin is the only means of confirming 
the diagnosis. 

•External tuberculosis of the retro-pharyngeal and cervical lym- 
phatic glands resembles, at a first glance, simple inflammation of 
lymphatic glands, but in the last-mentioned disease the lesions are 
symmetrical and the glands' still retain a certain amount of elasti- 
city, whilst in tuberculosis they are bosselated, hard, and sometimes 
fluctuating. 

Tuberculosis of the mediastinum is suggested by difficulty in swal- 
lowing, especially if tympanites follows soon after eating, eructation 
is absent, and rumination is arrested. 

A careful study of the development of the ulcerations will also in 
most instances make clear the difference betw^een tuberculous stoma- 
titis and simple stomatitis or stomatitis due to actinomycosis. Intes- 
tinal tuberculosis and tuberculous enteritis are sufficiently charac- 
terised by persistent intractable diarrhoea accompanied by tympanites, 

z z 2 



708 INFECTIOUS DISEASES. 

by the foetid character of the faeces, and by moderate but continued 
fever. Chronic diarrhoea, which alone presents some analogy with 
this condition, is never accompanied by permanent tympanites. 

Tuberculosis of the genital organs in male animals is always 
liable to be mistaken for simple orchitis and the development of 
tumours in the testicle ; an hijection of tuberculin will, how^ever, in- 
dicate the nature of the lesion. 

When the symptoms of genital disease or chronic mammitis in 
female animals suggest that the disease is of a specific character, 
the diagnosis can frequently be confirmed by a microscopical exami- 
nation of the pus or milk. 

Finally, should the practitioner hesitate as to the nature of the 
lesions which are the cause of arthritis, deformity of bones, cere- 
bral symptoms, etc., tuberculin again will in most cases settle the 
question. 

The prognosis in cases of tuberculosis is extremely unfavourable, 
whatever the form of the disease or its manifestations. Clinically 
the disease should be regarded as incurable in the strict sense of 
the word, however limited may be the lesions. The affected animals 
are not all doomed to immediate death : some may be kept alive, and 
may even serve an economic purpose without necessarily endangering 
others ; it is sometimes possible to fatten them, though the risks 
probably far outweigh the advantages, but one can never rely on 
recovery in any particular case. 

The gravity of this disease is the greater inasmuch as it assumes 
so many forms, any one of which may result in the infection of 
other animals. 

All those forms of the disease, such as tuberculosis of the respira- 
tory, digestive and genital tracts, in which virulent material con- 
taining bacilli is discharged realise these conditions. The patient 
becomes a source of infection to others of its kind, a fact which 
more than anything else renders the disease so dangerous to the 
farmer and breeder. 

Only in cases where the lesions are closed (as in tuberculosis of 
the lymphatic glands, serous membranes, joints, etc.) can the sufferers 
be regarded as innocuous, and — as these lesions are exceptional or 
at least, as animals suffering from them are very frequently afflicted 
with open lesions from which bacilli are continually being dis- 
charged — every tuberculous animal must be regarded from a clinical 
standpoint as a constant danger to its neighbours. 

This, however, must not be understood to mean that there are 
not different degrees of danger. It is quite certain that a patient 
with pulmonary caverns which are constantly throwing off enormous 



TUBERCULOSIS. 709 

quantities of material fall of bacilli is much more dangerous than 
another suffering only from slight bronchial or tracheal lesions, 
though the danger in the latter case is none the less always present. 

Treatment. There is no really curative treatment of tuber^ 
culosis. 

It must not be thought, however, that we are comjoletely helpless 
and that the present condition of affairs must be allowed to con- 
tinue indefinitely. Nocard and Leclainche have minutely laid down 
the lines to be followed as regards prophylaxis, though unfortu- 
nately the measures recommended cannot always be carried out. 

Tuberculin having been proved an exact means of detecting 
tuberculous lesions in animals even where none were suspected, it 
is desirable, firstly, to test all the animals in a given establish- 
ment with tuberculin ; and, secondly, to separate into classes (1) all 
animals which have reacted, and (2) those which have resisted. 

The stables, etc., should then be completely disinfected by 
sweeping, washing first with hot water, then with strong anti- 
septic solutions, brushing over the walls with quick-lime solution and 
fumigating with sulphurous acid or formic aldehyde. The healthy 
animals should then be placed in one shed and the diseased animals 
in another. In order to render this system of isolation really 
efficacious the isolated animals and the healthy animals sliould have 
nothing in common, and the persons tending the two classes of 
animals, the buckets and other utensils, the watering places, etc., 
should be kept rigorously apart. 

The animals known to be tuberculous should as rapidly as 
possible be prepared for slaughter, and if pregnant cows are included 
in the number the calves should be removed to the healthy stable 
immediately after birth and brought up either on boiled milk or by 
a healthy mother, experience having shown that congenital tuber- 
culosis is of rare occurrence. 

After the tuberculous animals have left the shed, this should 
again be thoroughly disinfected, in order to make it fit for the 
reception of healthy subjects. 

Unfortunately such precautions can only be observed in model 
establishments. They necessitate expenses and immediate sacrifices 
of a very serious character, and breeders too often view only the 
sacrifice without regard to the after benefits. For this reason the 
above system has only been practised in certain of the best known 
and best managed farms. 

To ensure the full benefit of these precautions, and to prevent 
a fresh introduction of tuberculosis into the herd, every new animal 
introduced should be subjected to the tuberculin test. Unless this 



710 INFECTIOUS DISEASES. 

precaution is taken, there is always a risk of introducing a tuber- 
culous subject, thus nullifying all the precautions previously taken. 

The problem is therefore still very complex, and the system can 
only give good results when rigorously observed and followed out. 

As, however, in spite of all precautions, animals regarded as 
healthy are always, under normal conditions of existence, more or 
less exposed to accidental infection, it is desirable to subject the 
entire herd to the tuberculin test annually. This would cause the 
immediate detection of any animals with latent infection, so that 
they could be removed from the herd. 

These wise precautions might, if understood and observed, 
eliminate the disease from the country, but they depend on indi- 
vidual initiative, and have not as yet been grasped by the mass of 
small breeders, farmers, etc. This class only see the difficulties in 
the way of realising the idea, without appreciating the constant 
benefit which they would derive from it. 

SWINE FEVER— VERRUCOUS ENDOCARDITIS AND PNEUMONIA 

OF THE PIG. 

Although it is not contemplated in this work to deal with those 
disorders which, on account of their highly contagious or infectious 
character, can only be dealt with by legislative action and by pro- 
cesses of "stamping-out," it may be permissible to make certain 
exceptions. While we have made no reference to contagious pleuro- 
pneumonia of cattle, foot-and-mouth disease, rinderpest, anthrax and 
black-quarter w^e have devoted some space to Texas fever and tuber- 
culosis, and give herewith a summary of the present state of know- 
ledge regarding swine fever or hog cholera and a haemorrhagic sep- 
ticaemia of cattle known under various names in different countries 
and of very wide distribution. 

SWINE FEVEE.* 

Swine fever may assume two distinct forms, viz., the acute and 
fatal and the non-acute or slowly progressive. 

Symptoms. In the acute form all those symptoms which are indi- 
cative of a severe febrile affection are present. The animals are 
disinclined to feed ; they present evidence of great prostration and lie 
about their dwellings in a listless manner sheltering themselves from 
cold ; their skins are hot, their eyes partially closed, and they are 
obviously suffering from some severe constitutional disturbance. Within 

* Keport of the Departmental Committee re Swine Fever. (Annual Keporfc of 
Board of Agriculture, 1896.) 



SWINE FEVER. 711 

a very few hours after these premonitory symptoms have set ui the 
pigs become rapidly worse ; they may or may not have a deep-red 
blush on the skin, which is more particularly noticeable on those 
parts of the body where there is an absence of hair, such as the 
inside of the thighs, the point of the axilla, and over the abdomen. 
Choleraic evacuations, having a most offensive odour, succeeding 
upon constipation, follow later on, and the animals die perhaps as 
early as the third or fourth day after the symptoms have first been 
observed. 

In some instances the disease proceeds with great rapidity 
through a herd, the symptoms being of a most aggravated and pro- 
nounced character, and the outbreak attended with great fatality. 

Generally speaking, the above description depicts the symptoms 
of swine fever in the acute form, more especially when it breaks 
out in a herd of young pigs. 

In the non-acute form the disease progresses slowly, the clinical 
evidence is extremely obscure, the reddening of the skin, formerly 
regarded as being invariably present in swine fever, is absent, and 
beyond the fact that the animal is unthrifty, develops slowly, and 
perhaps has a constantly relaxed condition of the bowels, it may be 
asserted that there are no symptoms which could be regarded as 
absolutely indicative of swine fever, and nothing short of a post- 
mortem examination will enable even an expert to satisfy himself 
that the animal was affected with the disease. 

As a general rule swine fever assumes this non-acute and slowly 
progressive form in pigs which have arrived at an age when their 
powers of resistance to disease are materially increased, i.e., in 
animals of eight or more months old ; on post-mortem examination 
they are found to have been extensively diseased, more particularly 
in the large intestine, a portion of the digestive apparatus which 
does not appear to perform any very important function in con- 
nection with the nutrition of the animal, and so long as the stomach 
and small intestines remain healthy, pigs with a considerable amount 
of disease in the large, intestine may still keep up their condition 
for a considerable time. 

Etiology. As regards the etiology of the form of swine fever 
prevalent in England no question now exists. It has been proved to 
demonstration by the bacteriological inquiry conducted by Professor 
McFadyean that it is due to a special pathogenic organism, a bacillus, 
which, after cultivation in artificial media, will produce in the healthy 
pig fed with the pure cultures the typical ulcerations which are 
found in the intestines of pigs affected with swine fever contracted 
in the ordinary way. 



712 INFECTIOUS DISEASES. 

The observations made by the veterinary officers of the Board 
of Agriculture caused them to doubt whether there was any disease 
of the lungs of pigs which, in the absence of lesions in the intes- 
tinal tract, could be accepted as evidence of swine fever. 

The bacillus which produced swine fever when introduced in the 
healthy pig did not induce any special disease of the lungs. 

Pathology and morbid anatomy. Swine fever, like typhoid fever 
in man, is essentially a disease of the digestive system, its chief 
characteristic being certain morbid changes of a well-marked nature 
which are found upon the surface of the mucous membrane in some 
part of the alimentary canal. 

The changes referred to consist of what have been commonly de- 
scribed as the formation of a series of ulcers, single or confluent, dis- 
tributed upon some part of the intestinal tract, varying in size and 
shape, of a yellowish-grey to black colour, and assuming as a rule 
a circular form. In some instances the lesions consist of diphtheritic 
exudations with necrosis of the lining membrane of the bowels. 

These ulcers or necrotic patches may be found upon the tongue, 
tonsils, epiglottis, stomach, and small intestines, but they are more 
constant in the large intestines, especially the caecum and colon. The 
lesions may involve the whole thickness of the mucous membrane, 
but seldom penetrate the other coats of the intestine ; in fact, perfora- 
tion of the peritoneal covering of the bowel is very rare in even 
prolonged cases of swine fever. 

In cases where swine fever assumes the more acute form and 
death supervenes rapidly, it is usual to find that the small intestines 
are largely involved. 

In the non-acute or slowly progressing form the lesions are more 
abundant in the large intestines, and in some instances the walls of 
the intestines become so thick as a result of infiltration into their 
structure and the excessively thick deposits upon the lining mem- 
brane, that it becomes a matter of surprise that the passage of the 
ingesta has been possible and that the animal has lived so long. 

Next to the intestinal lesions the congested condition of the lym- 
phatic glands, especially those of the mesentery, may be considered 
as most prominent among the pathological changes which occur in 
swine fever. Occasionally centres of necrosis are observed in the 
liver, and some writers refer to changes in or upon the spleen and 
kidneys. 

The onl}^ lesions which can be characterised as absolutely typical 
of swine fever are those present in the bowels, the absence of which 
will justify any observer in declining to accept the case as one 
of swine fever without some further evidence or inquiry. It must. 



VERRUCOUS ENDOCARDITIS OF THE PIG. 713 

however, be distinctly understood that in the case of very young pigs 
which have died shortly after infection, there is often an entire 
absence of the lesions described, the only changes present being 
inflammation of the stomach or some part of the intestines. 

Further, there are instances where older pigs have been slaughtered 
in the early stage of the disease in which no definite lesions have been 
found, and in such cases inquiry into the condition of the rest of the 
herd becomes necessary. 

One most important feature in connection with the morbid anatomy 
of swine fever is the disposition which many animals have to recover 
from the disease ; evidence of the reparatory process having often been 
detected in the intestines after they had been carefully washed. 

Dr. Klein also maintained that many pigs took the disease in the 
mild form, and recovered without presenting any of the marked 
symptoms of swine fever. 

It was found that, whether infected in the ordinary way or by 
direct inoculation, in some pigs killed only a few days after being in- 
fected the ulcers were occasionally seen gradually detaching from the 
surface of the intestines, and cicatrisation had already commenced. 



VERRUCOUS ENDOCA.RDITIS OF THE PIG. 

In the report of the Board of Agriculture for 1894 reference was 
made to the numerous instances in which the heart of the pig had 
been found affected with verrucous endocarditis. 

This form of disease of the heart was known to veterinarians in 
Great Britain as far back as the year 1847. For reasons given in 
that report it became obvious that this diseased condition of the 
valves of the heart was not produced by swine fever. The question 
arose whether in addition to swine fever another disease existed, 
known on the Continent under the name of swine erysipelas. The 
importance of this question will be appreciated when it is explained 
that on the Continent swine erysipelas is classed among the con- 
tagious diseases of the pig. 

The clinical evidence of the disease called swine erysipelas on the 
Continent appears to be more or less discoloration of the skin, similar 
to that which is frequently observed in swine fever, together with the 
occasional presence within the warty growths upon the valves of the 
heart of a bacillus which is regarded by Continental authorities as 
the cause of the disease. 

Early in the inquiry it was ascertained that a bacillus identical 
with that found in swine erysipelas was also present in the diseased 
portion of the valves of the heart of the pigs in this country. 



714 INFECTIOUS DISEASES. 

But the inquiries made did not corroborate or favour the suggestion 
that the disease which produced these morbid growths was in any way 
infectious or contagious. Such inquiries as could be made led to the 
opposite conclusion, since in every instance where the cases could be 
followed up it was ascertained that the deaths had been quite sudden, 
were limited to a single animal, and that those in contact remained 
in perfect health. 

At this stage the all -important point to determine was whether 
the disease which existed in this country, ''verrucous endocarditis," 
was communicable from pig to pig, and with this object numerous 
experiments have been conducted to discover whether the bacilli found 
within the hearts of diseased pigs were pathogenic to healthy swine. 

A large number of healthy pigs have been fed or inoculated with 
the blood, the diseased portions taken from the valves of the heart, 
and with artificial cultures of the bacilli obtained from the heart, 
but in no instance has the attempt to produce this disease been 
successful. 

PNEUMONIA OF THE PIG. 

The occasional association of pneumonia with or without pleurisy 
in cases of swine fever has led many veterinarians in England to 
regard lung complications as one of the lesions produced by that 
disease. 

In the Board of Agriculture's report for the year 1894 a description 
was given of the various diseases in the lungs of swine which had 
come under notice, and it was therein stated that the Board had 
been unable to discover any special lesion of the lung which would 
warrant them in stating that it was indicative of swine fever or due 
to contagion. 

It is an indisputable fact that pigs are extremely liable to pneumonia 
and pleurisy. But as the clinical appearances present in the lungs 
examined in no wise differed from those which take place in the lungs 
of other animals which have been exposed to cold or septicsemia and 
other causes, the Board's officers have never accepted these lesions as 
being specific. 

It is well known that both in Germany and the United States out- 
breaks of pneumonia of a contagious nature attributed to the presence 
of a bacillus pathogenic to the pigs of those countries are reported to 
occur. Indeed, contagious pneumonia of swine under the names of 
schweinesuche in Germany and swine plague in America are regarded 
as one and the same disease. 

In view of the fact that in a large number of cases pneumonia, 
more or less extensive, sometimes associated with pleurisy, was found 



PNEUMONIA OF THE PIG. 715 

among the specimens forwarded to London, it was considered desirable 
that the departmental committee should institute a series of experi- 
ments to decide whether we had in this country a form of pneumonia 
in the pig w4iich was communicable from one pig to another. 

Accordingly a series of bacteriological experiments were conducted 
by Professor McFadyean with a view to isolate, if possible, a micro- 
organism which would be capable of inducing pneumonia in healthy 
pigs. A number of diseased lungs, some of which w^ere taken from 
pigs affected with swine fever, were examined microscopically by him, 
and, as was to be expected, several organisms were isolated, but they 
proved to be morphologically and culturally different from the bacillus 
of swine fever. Inoculations were carried out with these organisms 
not only subcutaneously but directly into the lung through the walls 
of the chest, and feeding experiments were also conducted. The 
results of these experiments were entirely negative ; a certain amount 
of local injury was caused to the lungs at the seat where they had 
been punctured, but in no case was either pneumonia or swine fever 
induced. 

The experiments have therefore demonstrated that the pneumonia 
found in the lungs of pigs affected with swine fever is not due to the 
swine fever bacillus. 

The departmental committee arrived at the conclusion that the 
pneumonia which is occasionally encountered as an independent 
disease of the pig or in association with swine fever is not ascribable 
to contagion, but to the presence of organisms which are generally 
saprophytic in their mode of life, and which only in particular cir- 
cumstances (such as lowered vitality and diminished resistance on the 
part of the pig) are able to multiply in the air passages and lung 
tissue and thus induce pneumonia ; and it appeared to the departmental 
committee that in this country pneumonia of the pig is sporadic and 
not contagious or epizootic. 

CONCLUSIONS. 

There is now no reason whatever to believe that there exists at 
the present time in Great Britain any disease of a contagious nature 
affecting pigs other than swine fever. The disease of the heart, 
" verrucous endocarditis," and the pneumonia which are so frequently 
met with in pigs cannot be regarded as lesions indicative of an attack 
of swine fever. 

As regards verrucous endocarditis and pneumonia, it may safely 
be said that they do not exist in England in a contagious form. 

Considering all the evidence, it may reasonably be concluded that 
the departmental committee were correct in their views when they 



716 INFECTIOUS DISEASES. 

stated that " the evidence obtained during the whole inquiry justifies 
the conclusion at which they have arrived, viz., that there is no 
epizootic of swine except s\Yine fever in any part of the United 
Kingdom which requires to be dealt with under the provisions of 
the Act of 1894." 

Finally, it may be said that the great factors in perpetuating swine 
fever will always be pigs which are affected with that disease in the 
less fatal and unrecognisable form. These animals are constantly 
distributing the germs of swine fever through their highly infective 
evacuations wherever they may be taken during the whole period of 
their illness, and the final extinction of the malady must depend upon 
the possibility of enforcing measures which will have the effect of 
preventing the movement of pigs affected with swine fever in this 
particular form. 

HEMORRHAGIC SEPTIC/EMIA IN CATTLE- 

In 1902 Drs. Wilson and Brimhall, of the State Board of Health of 
Minnesota, U.S.A., described under the title of " hsemorrhagic septi- 
caemia of cattle " a widespread infectious disease of bovines which has 
the following general characteristics : — The disease is distributed the 
world over, but is apparently most common in low-lying regions, 
and most general in wet seasons. The animals attacked are of all 
ages. The onset of the disease is sudden, its course rapid, and its 
termination usually (90 to 98 per cent.) fatal. Thirty to 90 per cent. 
of all animals in an infected herd die. The clinical symptoms are 
refusal of food, cessation of rumination and lactation, initially increased 
temperature (107° to 109° F. : 42° to 43° C), rapid, laboured breathing, 
sometimes bloody discharge from nostrils, bladder, and bowels, and 
non-crepitant swellings in the throat region, back of shoulders, or 
about the fetlocks. The most striking pathological lesions are 
haemorrhages from 1 millimetre to 20 centimetres in diameter, through- 
out the subcutaneous, submucous, subserous and intermuscular con- 
nective tissue, infiltrating the lymphatic glands, and involving several 
or all of the internal organs. The spleen is neither enlarged nor 
darkened. The causative bacteria, which may be isolated from the 
larger hsemorrhagic areas, lymph glands, heart's blood, lung, spleen, 
etc., have the following distinguishing characteristics : 

Ovoidal bacilli, with rounded ends of 0*5 to 0'8 microns in trans- 
verse diameter, and 1"0 to 1*5 microns in length; sometimes paired and 
sometimes in chains of three to six individuals. The bacilli in the 
tissues exhibit polar staining with an unstained "belt" or "middle 
piece." They are non-capsulated, non-spore-forming, non-Gramstain- 
ing, and non-motile. They grow best aerobically at 98*5° F. (37° C), 



HEMORRHAGIC SEPTICEMIA IN CATTLE. 



717 



though capable of developmg anaerobically and at room temperature; 
prefer the depths rather than the surfaces of media ; grow feebl}^ if at 
all, on potato ; fail to liquefy gelatine ; produce acid, but no gas in 
glucose media, neither acid nor gas in lactose media ; and develop 
varying amounts of indol and phenol in peptone solution. The 
organisms have been named Bacillus hovisepticus. The lesions of the 
disease are reproduced in cattle and other animals by inoculation of 
pure cultures of the organism. 

It should be insisted upon that the identification of the disease in a 
locality in which it has not been previously described, or by veteri- 
narians not having had previous experience therewith, shall take into 
consideration — (a) the essential clinical symptoms ; (b) the 2)athological 
lesions as observed before the onset of decomposition ; and (c) the morpho- 
logical and biological identification of the specific bacilli. 

The following is a tabulated list of the principal epidemics so 
studied and reported to January 1st, 1901 : 



Table showing the Principal Epidemics of Hemorrhagic Septicaemia 
in Bovines due to Bacillus hovisepticus. 



Name of observer. 


Year. 


Locality. 


Local or reporter's name of disease. 


Bollinger . 


1878 


Germany 


Wild und Rinderseuche. 


Kitt .... 


1885 


,, 


Rinderseuche. 


Kitt .... 


1887 


,, 


Septikaemia hsemorrhagica. 


Poels 


1886 


Holland 


Septic pleuro-pneumonia of calves. 


Oreste et Armanni . 


1886 


Italy 


Barbone. 


Jensen 


1889 


Jutland 


Rinderseuche. 


Plot .... 


1889 


Egypt 


Kounnaq. 


Van Eecke . { 


1890 
1895 


Java 


Septichaemia haemorrhagica. 


Hubenet . 


1895 


,, 


,. „ 


Galtier . 


1891 


France, imported 
from Algiers 


Infectious pneumo-enteritis. 


Reischig . 


1891 


Hungary 


Maladie des buffles ou Angine 
Charbonneuse. 


Bongartz . 


1892 


Germany 


Wild und Rinderseuche. 


Jakobi 


1892 


,, 


AVildseuche. 


Buch 


1892 


) J 


Hsemorrhagische septikaemia. 


Giillebeau and Hess . 


1894 


?5 


Septikaemia haemorrhagica. Char- 
bon Blanc. 


Fischer . 


1895 


Dutch Indies 


Septichaemia haemorrhagica. 


Leclainche 


1895 


France 


Pneumo - enteritis . 


Von Ratz . 


1896 


Hungary 


B arbonekr ankheit . 


Sanfelice, Loi, and 


1897 


Sardinia 


?? 


Malato 








Bosso 


1898 


Italy 


Septicaemia haemorrhagica. 


Pease 


1898 


British India 


Ghotwa or Ghotu. 


Lignieres . 


1898 


Argentina 


Pasteurellosis bo vina. ' ' Diarrhoea ' ' 
and " Enteque." 


Fenimore . 


1898 


Tennessee 


Wild and catt e disease. 



718 INFECTIOUS DISEASES. 

It may not be out of place to give at this point a short list of 
the principal infective diseases of definitely known aetiology, with 
which haemorrhagic septicaemia in cattle has been, and may readily 
be, confused : 

Name of disease. Diagnostic jpoints. 

Anthrax ....... Altered condition of blood, enlarged spleen, 

presence of B. anthracis, etc. 
Black-quarter ...... Usually localised lesion, crepitant tumour, 

presence of B. anthracis symptomatici. 
Septicpneumo-enteritis of calves (Gal tier) Due to a spore-bearing bacillus—" Pneu- 

mobacillus sejytictis'' — whicb grows 

rapidly on potato. 
Septicaemia of calves . . . . Due to typhoid-like bacilli. 



CONCLUSIONS. 

(1.) Eight outbreaks of haemorrhagic septicaemia in cattle due to 
B. hovisepticus occurred in Minnesota from August to December, 1900. 

(2.) So far as can be determined, the only other outbreak of this 
disease hitherto published as occurring in America was one near 
Knoxville, Tenn., in 1898. The foci of the disease have also apparently 
been present in Texas and the district of Colombia. No relation can 
be traced between the disease elsewhere and the present outbreaks, 
nor between any two of the present ones. 

(3.) Of 160 animals in the eight herds, sixty-four showed symptoms 
of the disease, and all such died — a mortality of 40 per cent, of all 
the animals in the herds, and of 100 per cent, of those showing 
symptoms. 

(4.) The chief symptoms were loss of appetite, fever, stiffness, 
swelling of the legs and throat, and a black, tarry, or bloody dis- 
charge from the bowels. Bloody urine and bloody nasal discharge 
were present in some cases. Death occurred usually in from six to 
twenty-four hours after the first appearance of symptoms. 

(5.) The chief lesions discovered at autopsy were ecchymoses, and 
small and large haemorrhagic areas in the subcutaneous connective 
tissues, muscles, lymph glands, and throughout the internal organs. 
The cervical lymph glands, heart muscle, and alimentary canal were 
most affected. The spleen was not enlarged nor • darkened (except 
after onset of decomposition). 

(6.) From the twenty-two animals on which autopsies were made 
the same bacillus was obtained from all the tissues examined. Where 
the examination was made immediately after death — nine cases — it was 
unmixed with any other organism. 



HEMORRHAGIC SEPTICEMIA IN CATTLE. 71 9 

(7.) The bacillus was identified as belonging to the hemorrhagic 
septicaemia group of Hiippe, best specifically designated as B. hovi- 
sejjticus ; and besides causing hsemorrhagic septicaemia in cattle (syno- 
nyms — rinderseuche, buffleseuche, barbone, khounnaq, charbon blanc, 
ghotwa, pasteurellosis bovina, etc.), closely resembles, if, indeed, it 
is not identical with, the bacilli causing wildseuche, swine plague, 
schweineseuche, rabbit septicaemia, chicken cholera, grouse disease, 
duck cholera, etc. The organism was studied in direct coverglass pre- 
parations, parallel cultures in and on various media, and b}' inoculation 
of animals in which the characteristic lesions were reproduced, and 
from the tissues of which the inoculated bacilli were recovered in pure 
culture. 

(8.) An attempt was made to immunise cattle by the injection of 
filtered, and later of the killed, cultures of the bacillus. The chief 
difficulties met with were in maintaining the virulence of the bacillus 
on artificial media, and in determining the proper dosage. The 
experiments were too few, and the results not sufficiently tested to 
warrant conclusive statements as to the protective value of the in- 
oculations, but it would appear that a fairly high degree of immunity 
was produced. 

(9.) The prompt removal of the dead animals and isolation of sick 
ones, accompanied by thorough disinfection by fire, carbolic acid, 
corrosive sublimate, and freshly-slaked lime, apparently served to 
check each outbreak within a short time after the measures were 
instituted. 



SECTION XL 
OPERATIONS. 

CHAPTER I. 

CONTROL OF ANIMALS* 

CONTROL OF OXEN. 

The safe and efficient performance of surgical operations renders 
it necessary that the animal should first of all be placed under 
complete control. This precaution, therefore, is the first to merit 
attention. Animals are either secured completely or to a more or 
less limited extent, according to circumstances. The ox, for example, 
may be secured by the head, one or more limbs may be fastened, or, 
by being placed in a trevis, the whole of the animal may be secured. 

PARTIAL CONTROL. 

(1.) The simplest method of securing the ox is to grasp the nostrils 
or lower extremity of the septum nasi between the thumb and index 
finger of the right or left hand (Fig. 57). 

(2.) This method may be rendered more complete by the assistant 
passing his arm from behind forward over the animal's head between 
its horns, and then grasping the nostrils as above described, whilst 
one of the horns is firmly held with the other hand (Fig. 58). 

(3.) A third method consists in fixing the head to a post, tree, 
fence, or other solid body, by passing a rope round the base of the 
horns and tying it to the object selected. 

CONTROL OF THE LIMBS. 

To prevent the animal kicking or moving about during an opera- 
tion it is sometimes necessary to fix the limbs. A front leg may be 
lifted as for shoeing, or may be kept lifted by means of a rope passed 
around the fetlock, over the withers, downward between the front 
legs, outside the forearm, in front of the chest and inside the pastern, 
after which one or more turns may be m de around the pastern to 
prevent the rope slipping. 



CONTROL OF OXEN. 



721 



A hind limb may be secured in a simple \Yay by passing the end 
of the tail round it in front of the hock (Fig. 284) ; any violent and 
extensive movement of the limb is then necessarily painful to the 
animal owing to the tension of the tail. 

Greater security, however, is given by i3assing a rope backward 
and forward around the hind legs, above the hocks, in the form of 




Fig. 284. — Fixinor the head and a hmd limb, 



a figure of eight (Fig. 285). This does not prevent all movements of 
the hind limbs, but it limits them and secures both animal and 
operator from danger. 

Should it become necessary to examine the hind foot or inter- 
digital space, it is useful at times to pass a loop of cord round the 
leg in the region of the tendo Achillis, and 
to twist and tighten this loop by a short, 
stout stick passed through it ; this is the leg 
twitch described in Dollar's " Operative Tech- 
nique," p. 7. 

For such examinations, however, the 
animal is usually placed in the trevis, or is 
secured to the side of a long waggon (Fig. 286). 




To secure the limbs beneath the abdomen pj^_ 285 — Fixmg the 



hind 



limbs. 



a strip of webbing or a rope is fastened round 
the pastern, passed between the fore limbs, 

then in front of the shoulder of the opposite side, over the withers and 
beneath the elbow of the same side, being secured with a slip-knot. 
For castration in the standing position a hind and a fore limb 
may be fastened together, as shown in Fig. 287. 

In examining the sole of the hind claws, the animal's head may 
D.c. 3 A 



722 



OPERATIONS. 



be secured to a tree, and the hind limb lifted by a strip of webbing 
or rope fixed to the body of a waggon (Fig. 288). 

GENERAL CONTROL. 

General control in the standing position can only be made really 




Fig. 286. — Fixing a front limb. Examining a hind foot. 

effective by using the trevis, in which both the head and the fore 
and hind limbs are secured. 

The practitioner, however, is often content with much less perfect 




Fig. 287. — Fixing two limbs of one side for the operation of bistournage. 

methods, using either the so-called " bulldogs " or the nose ring, which 
may usually be so manipulated as to control all but the most dangerous 
animals. The nose ring is seldom employed except for bulls, which 



CONTROL OF OXEN. 



723 



are usually ringed at an early age; the ''bulldogs" can be employed 
and removed at will. 

In inserting a nose ring the head is securely fixed, the centre 
line of the muzzle is grasped with the left hand, and the septum 
nasi is pierced wdth a straight bistoury, the cutting edge being 
turned in a backward direction ; the aperture being thus prepared, 
the ring is introduced and fixed. Some operators prefer to use a 
trocar, slightly exceeding in diameter the ring to be worn ; in that 
case the manual technique is the same. The puncture is made, the 
trocar alone is withdrawn, and the canula remains in situ; one 
extremity of the ring is then inserted into the canula, and both 




Fig. 288. — Fixing an ox for the examination of a hind limb. 



are drawn through the septum together. There is no difficulty in 
thus inserting the ring, though puncture with the trocar is perhaps 
rather less convenient th'an with the bistoury. 

Eelative control without casting may also be effected by attaching 
the end of the tail to the base of the horns or the head to the cannon 
bone of a front or hind limb. These methods, however, are of little 
value except to prevent animals at grass from escaping entirely during 
operation. 

CONTKOL BY CASTING. 

Oxen should always be cast on a thick straw bed to avoid fracturing 
the horns. 

The simplest method consists in using hobbles and ropes, as for 
the horse. 

8 A 2 



724 



OPERATIONS. 



though 



Another, 
ropes, each fixed 
front, 



the 



then 



less 

to the 

the hmd 



practical, method consists in using two long 



B 



base of the horns and passed first between 
limbs, round the hind pasterns from within 
outwards and then brought for- 
ward (Fig. 292). When the ropes 
are draw^n tight by assistants 
standing in front of the animal, 
the latter usually falls on its 
hocks and rolls over to the right 
or left, according to the direction 
given to it. 

A third method is particularly 
useful in young or feeble animals. 
It consists in fixing around the 
horns a rope about eight to ten 
yards in length, the free end of 
which is carried along the upper 
margin of the neck and back. A 
loop is formed embracing the base 
of the neck, a second behind the shoulders in the region occupied 
by the girth, and a third around the flanks (Fig. 293). By pulling in 
a backward direction the rope is drawn tight, and the animal first 
backs and afterwards falls on its hocks, subsiding either to the right 
or left, as in the case previously mentioned. 





Fig. 289. — A, " bulldogs " operated by a 
screw ; B, " bulldogs " with a sliding ring. 





Fig. 290. — Nose ring open for insertion. 



Fig. 291. — Nose ring closed. 



In using either of these two methods it is very important, as 
soon as the animal falls, to secure the limbs in a certain way, ac- 
cording to the nature of the operation to be performed. This can 
be effected with hobbles and ropes passed round the hocks, above the 
knee, etc. 



CONTROL OF OXEN, SHEEP, GOATS, AND PIGS. 



126 



CONTROL OF SHEEP AND GOATS. 

The above animals may be secured, whilst standing, by grasping 
the head and neck or, when cast by crossing the front and hind 




Fig. 292. 

limbs in the form of an X ai^<^ ^.yii^g ^ soft rope or piece of webbing 
round the crossing- of the limbs. 




Fig. 293. 



CONTROL OF PIGS. 



No difficulty is usually experienced in controlling young pigs, either 
when standing or cast, only one or two assistants being required, but 



?26 



OPEKATIONS. 



aged animals are more difficult and more dangerous to deal with, 
and by their tusks sometimes inflict severe wounds. 

In the standing position they can be partially fixed by passing a 
running loop behind the canine teeth 'of the upper jaw, but should 
the examination to be carried out prove to be of a difficult character 
it is best to cast the animal. 

A' strong assistant grasps one of the hind limbs by means of a 
running loop, fixed, for example, above the right hock. He rapidly 
slides his left knee towards the front of the left side of the chest, 
passes his left hand over the withers, and by the combined use of 
his knees and arms throws the animal on its left side, controlling 
as far as possible the struggles of the right front and hind limbs, 
which he grasps with his hands. 

The animal is then further secured by rapidly passing a thin rope 
in figures of eight around the front and hind limbs. If necessary 
all four legs may be brought together and fastened by a rope passed 
round the region of the pastern; a muzzle can afterwards be applied 
to prevent biting. 

AN/ESTHESIA. 

Oxen rarely receive general anaesthetics, though in certain obste- 
trical cases they may be necessary. Ether and chloroform are given 
by inhalation, and chloral of 10 to 20 per cent, strength by intra- 
venous injection. In utilising the latter method the injection should 
be made slowly, the pulse and heart being closely scanned to prevent 
cardiac syncope. The dose of chloroform varies with the size of the 
animal, 2 ounces often sufficing for a full-grown ox. The same methods 
may be used for sheep, goats, and pigs, the doses being suitably 
altered. (For fuller particulars see Dollar's "Operative Technique," 
pp. 44 to 70.) 

Most frequently, however, the surgeon contents himself with pro- 
ducing local anaesthesia by the injection of a 4 to 10 per cent, solu- 
tion of cocaine. 



CHAPTER 11. 
CIRCULATORY APPARATUS* 

BLEEDING. 

Bovine animals are usually bled from the superficial jugular, or 
the mammary vein. 

Bleeding from the Jugular. — The animal having been suitably 
fixed, the jugular is raised by means of a cord drawn tightly round 
the base of the neck, and the vessel is opened with a fleam about 
the middle of the neck. 

The skin of the ox being thick, a long-bladed instrument is 
necessary. When the bleeding ceases, the cord is removed : some 
practitioners take no precautions as regards the wound ; it is better 
to insert a pin suture. 

Bleeding from the jugular may also be performed with the trocar, 
particularly in animals with fine, thin skin. 

Bleeding from the Mammary Vein. — The mammary vein may be 
opened with the fleam, the straight bistoury, or the lancet. The head 
is firmly fixed and the hind limbs controlled by a rope passed in a 
figure of eight above the hocks. 

In bleeding on the left the operator places himself at an angle to 
the animal's side, opposite the hypochondriac region, with his back 
towards the animal's head, and holds the fleam in his right hand. 
To operate on the right-hand side the fleam is held in the left hand. 

This method of bleeding always causes thrombus formation, on 
account of the low position of the opening in the vein. The animal's 
bed should be kept very clean, in order to prevent any local infec- 
tion which might cause hsemorrhagic or suppurative phlebitis. The 
lancet or bistoury can only be used in animals with very fine skin. 

In bovine animals small quantities of blood are sometimes taken 
from the facial vein or the veins of the ear or tail. 

BLEEDING IN SHEEP. 

On account of the quantity of fatty tissue and wool covering the 
jugular furrow in the sheep, bleeding is scarcely practicable at that 



728 



CIRCULATORY APPARATUS. 



point. The operation is usually performed on the angular vein of 
the eye, the external saphenous vein, or the subcutaneous vein of 
the forearm. 

In operating on the facial vein the animal's head is firmly held, 
the operator compresses with the fingers of his left hand the facial 
vein at the point where it passes into the maxillary fissure, and with 
a lancet opens the angular vein of the eye or one of the other 
branches of origin which project prominently beneath the skin. 
Bleeding ceases as soon as the pressure is relaxed. 

In the case of the external saphenous vein, the vein is raised by 
compressing the middle region of the limb and the vessel is opened 
with a lancet, a little above and towards the outside of the hock. 

The subcutaneous vein of 
the forearm can be raised 
by compressing the fore limb 
I^B^^^^^^^^^^^ below the elbow. The vein 

is visible throughout the 
length of the inner surface 
of the radius, and can easily 
be opened with a lancet. 

It is also possible to with- 
draw small quantities of blood 
by opening the marginal veins 
of the ear. 




Fig. 294. 



-Angular vein of the eje and 
facial vein. 



BLEEDING IN THE PIG. 

Breeders sometimes bleed 
by slitting one of the animal's 
ears or cutting the tail. It 
is preferable to bleed with a lancet from the marginal veins of the 
ear, the external saphenous vein a little above the hock, or the sub- 
cutaneous vein of the forearm. 



SETONS, ROWELS, PLUGS, OR ISSUES. 

Although the application of setons is still practised in horses, that 
of "issues" has largely been given up in bovine animals, although 
some practitioners still regard issues as of considerable value and 
as producing effects similar to, or better than, those of sinapisms. 

They are usually inserted in the region of the dewlap ; the materials 
employed comprise black and white hellebore, veratrine and stems of 
clematis. 



SETONS, EOWELS, PLUGS, OR ISSUES. 729 

Two methods are practised. 

In the first, a transverse fold is raised in the sldn of the 
dewlap, w^hich is divided with a stroke of the bistoury, leaving a 
little aperature in the skin. By introducing the rounded ends of a 
pair of curved scissors the subcutaneous connective tissue is broken 
down, leaving a little space beneath the skin, into which the plug 
is introduced. Swelling takes places very rapidly — in tw^enty-four 
to forty-eight hours it is very considerable — and if the substance- 
employed is violent in its action, like hellebore, it must be with- 
drawn, as otherwise considerable sloughing takes place. To facilitate 
this object a thread or piece of string is usually attached to the 
plug before it is inserted. 

In the second method, the irritant material is attached to, 
or smeared on, a strip of broad linen tape which is passed in pre- 
cisely the same manner as in the horse (see Dollar's " Operative 
Technique," pp. 107—111). 



CHAPTER III. 

APPARATUS OF J LOCOMOTION- 

The customary operations on the apparatus of locomotion are 

almost entirely confined to the feet. They 
consist in operations for sand-crack, picked- 
up nail, stabs by nails and bruising of the 
sole, elsewhere mentioned. As they call 
for no special precautions they need not 
be further mentioned here. 



SURGICAL DRESSING FOR A CLAW. 

The surgical dressing necessitated by the 
operation for sand-crack, picked-up nail, or 
injury to the heels is often very difficult to 
fix in the ox, and necessitates a support 
round the pastern. It can, however, be 
secured in the following way : 

The seat of operation is covered with 
small antiseptic pads, which are also ap- 
plied round the pastern and in the inter- 
digital space. A bandage is then passed 
twice round the pastern and over the pos- 
terior two-thirds of the claw, as in fixing 
the dressing used after removal of the lateral 
cartilage in the horse. The bandage is then 
passed repeatedly round the pastern in an 




Fig. 295. — Dressing for claw 
after operation. 



upward direction and tied above the interdigital space. 



AMPUTATION OF THE CLAW OR OF THE TWO LAST 

PHALANGES. 

It sometimes happens that certain grave diseases in the foot or 
pastern (stabs or picked-up nails, panaritium of the interdigital space, 
necrosis of the ends of the flexor tendons, etc.) are accompanied by 



Amputation of the claw or of the two last phalanges. 731 

necrosis of the bones, suppurative synovitis, and even suppurative 
arthritis of the second and first inter-phalangeal joints. 

If carefully treated these forms of arthritis may disappear, leaving 
the joints anchylosed, but unfortunately the application of the 
necessary antiseptic injections (free injection with warm boiled water, 
injection of 10 per cent, iodised glycerine, 3 per cent, carbolic glycerine 
or '1 per cent, sublimate) is difficult and costly. 

It is better, in such cases, to remove the claw or the two last 




Fig. 296. — Anatomical relations of 
the inter-phalangeal joints. 




Fig. 297. — Disarticulation of the 
claw and third phalanx. 



phalanges. With antiseptic precautions the stump heals, and recovery 
takes place without the interminable suppuration and pain which 
otherwise cause such grave loss of condition. 

(1.) Disarticulation of the Claw and Third Phalanx.— The 
patient is cast and suitably fixed. The horn-secreting coronary band 
of the claw must be preserved. 

First stage. The horny wall immediately beneath the coronary band 
is thoroughly thinned and the tissues are divided as far as the bone. 



732 



APPAEATUS OF LOCOMOTION. 



Second stage. Disarticulation : The tendon of the extensor pedis 
is divided and the joint opened. The claw is pressed backwards, and 
first the external and internal ligaments, then the flexor tendons of 
the phalanges, are divided. 

This operation is of no great use, because, on account of the 
position of the joint and the arrangement of the articular surfaces, 
the end of the second phalanx extends beyond the line of section. To 
avoid complications, therefore, it is better to remove the lower extremity 




Fig. 298. — Amputation of the 
two last phalanges. First 
and second phases. 




Fig. 299. — Amputation of the two 
last phalanges. Third phase. 



of the second phalanx, which, moreover, is always injured to a greater 
or less extent in cases of pedal arthritis. To effect this it is only 
necessary to draw back the flap of skin a little and rapidly divide the 
second phalange at its upper third with a fine saw. The points of 
section of the tendons and ligaments must be carefully examined, and 
if they exhibit necrosis should be further shortened. 

The stump is enveloped in a surgical dressing fixed to the pastern. 

Amputation of the two First Phalanges. — When necrosis is 
very serious and has extended a long way upwards, it is often better 
immediately to resort to amputation of the two last phalanges. 



AMPUTATION OF THE CLAW OR OF THE TWO LAST PHALANGES. 733 

The region is first shaved and thoroughly cleansed. The coronary 
band of the claw is also preserved in this case. 

First stage. The horn below the coronary band is thoroughly 
thinned and the tissues are divided as far as the bone. 

Second stage. The skin covering the front of the limb is verticall}^ 
incised from the lower third of the first phalanx (Fig. 298) to the 
coronary band ; the skin is separated and external and internal flaps 
are formed. 

Third stage. The extensor pedis tendon is divided, the first 
inter-phalangeal joint opened, the internal and external .lateral liga- 
ments are divided, the claw is pressed backwards, and the flexor 
tendons are also divided. 

To facilitate disarticulation, and particularly to facilitate section of 
the lateral ligaments, the claw is rotated successively outwards and 
inwards. 

According to circumstances, the lower extremity of the first 
phalange is either scraped or divided and the stumps of the tendons 
are carefull}^ trimmed to a regular shape. 

A surgical antiseptic dressing is applied over the whole of the 
seat of operation. 

Several other methods of performing this operation will be found 
in Moller and Dollar's " Eegional Surgery," pp. 831 — 835. 



CHAPTER IV. 

DIGESTIVE APPARATUS* 

RINGING PIGa 

This operation is customary in countries where pigs are allowed to 
roam more or less at liberty, and it is necessary to adopt some pre- 
caution to prevent them from uprooting the soil and thus causing 
damage, but the practice tends nowadays to disappear. It simply 

consists in passing through the 
nose some object which on 
being rubbed against anything 
causes pain and thus checks 
the animal's natural proclivity. 
Numerous methods have 
been suggested. One of the 
simplest is as follows : The 
animal having been cast, suit- 
ably secured and muzzled, two 
thick iron wires sharpened at 
the ends are passed through 
the snout, and the two ends 
are then twisted together in 
the form of two rings. These 
can, if necessary, be united. 
Another method, perhaps even more efficacious, consists in bending 
a thick wire into the shape of the letter \J, and preparing a small 
metal plate with two holes corresponding in position to the distance 
between the two nostrils. The ends of the wire, being sharpened, are 
passed through the nostrils and securely united to the metal plate by 
being bent into a spiral or simply at right angles. 




Fig. 300. — "Ringing" the pig. 



CESOPHAGUS. 

The operations practised on the oesophagus comprise passage of 
the oesophageal sound or probang, taxis, crushing of foreign bodies 
within the oesophagus, and oesophagotomy. 



(ESOPHAGUS. 73 i 



PASSING THE PEOBANG. 



Passage of the probang is called for in cases of marked tympanites, 
suspected dilatation or contraction of the oesophagus, and accidental 
obstruction. Special or improvised instruments may be used, accord- 
ing to circumstances. 

The animal is secured in a standing position with the head 
extended on the neck and in a straight line with the body. A gag 
is placed in the mouth and the tongue is grasped and withdrawn by 
an assistant, whilst the operator, having carefully oiled the probang, 
passes it through the gag towards the back of the pharynx. 
Violence should be avoided, the probang being gently slid along 
the centre of the vault of the palate. When the animal makes 
swallowing movements, the apparatus is slowly pushed onwards. 

This manipulation, though simple, requires some dexterity, because 
at the moment when the instrument enters the pharynx the animal 
often thrusts it to one side or the other with the base of its tongue, 
bringing it between the molar teeth, and so crushing, or at least 
injuring it. 

The passage of hollow probangs gives comparatively little relief 
in cases of tympanites, because the probang is almost always ob- 
structed by semi-digested material from the rumen, or plunges into 
the semi-solid masses of food contained therein. 

When the oesophagus is dilated at a point within the thorax, the 
progress of the probang is checked by the accumulated food material, 
and it becomes possible to determine approximately the place where 
the dilatation occurs. In the same way, should a slender probang 
be arrested at a given point in the oesophagus, this indicates that 
there is contraction of the tube at that point. 

In cases of obstruction the cupped probang is always arrested by 
the foreign body. Efforts to thrust the latter onwards should always 
be made with great caution, otherwise the oesophagus may be greatly 
distended or its walls even ruptured. 

CRUSHING THE FOREIGN BODY. 

No attempt should be made to crush a foreign body within the 
cervical portion of the oesophagus unless it is quite certain that that 
body is of comparatively soft character. Crushing may be performed 
by lateral pressure with the fingers within the region between the two 
jugular furrows, or mechanical means may be adopted. 

In the latter case a small piece of board is applied to one side of 
the neck behind the foreign body, whilst gentle blows are given from 



736 DIGESTIVE APPARATUS. 

the opposite side with a little wooden mallet. Whatever precautions 
may be taken, however, this method cannot be recommended. 

The same remark applies to the use of forceps, the jaw^s of which 
are so fashioned as to escape pressing on the trachea whilst they grasp 
directly the foreign body through the walls of the oesophagus. 

(ESOPHAGOTOMY. 

CEsophagotomy, or incision of the cesophagus, is an operation which, 
though sometimes necessary, should only be regarded as a last resort 
after all other methods have failed. Unfortunately it can be per- 
formed only in the region of the neck, and even then the most 
favourable point (viz., the lower third of the jugular furrow) cannot 
always be selected, the operation having to be performed directly 
over the foreign body. 

The animal may be either standing or lying down. The seat of 
operation should be thoroughly cleansed and disinfected. 

First stage. Incision through the skin and subcutaneous connective 
tissue above the level of the jugular vein and opposite the foreign body. 

Second stage. Isolation of the oesophagus by dissection and tear- 
ing through of the connective and fibro-aponeurotic tissue at the base 
of the jugular furrow. 

Third stage. Incision through the oesophagus for a distance just 
sufficient to enable the foreign body to be extracted. 

Fourth stage. Suturing of the mucous membrane, suturing of 
the muscular w^alls of the cesophagus, suturing of the skin, precautions 
being taken to allow of drainage at the lower part of the operative 
wound. 

SUB-MUCOUS DISSECTION OF THE FOREIGN BODY. 

As oesophagotomy, despite every precaution, often leads to fistula 
formation, Nocard has recommended sub-mucous dissection of the 
obstructive body, such body being usually semi-solid. This method 
has considerable advantages. 

The first and second stages of the operation are exactly the same 
as those above mentioned. 

The third stage consists in puncturing the walls of the oesophagus 
wdth a straight tenotome immediately behind the foreign body, as in 
tenotomy. A curved, button-pointed tenotome having next been 
introduced and passed with the blade flat between the foreign body 
.and the mucous membrane of the oesophagus, it is turned on its axis, 
and attempts are made to divide the obstruction. A few moments 
are often sufficient to effect this, after which the substance may be 
further broken up by the fingers. 



Et^MEN. 



im 



These various methods may lead to delayed compHcations, such as 
dilatation or contraction of the mucous memhrane of the oesophagus, 
muscular atrophy of the oesoj)hageal walls, oesophageal 
fistula, and, sometimes, abscess formation. 

RUMEN. 

Two operations are currently performed on the rumen, 
puncture and gastrotomy. 

PUNCTUEE OF THE RUMEN. 

Puncture of the rumen is essentially an urgent opera- 
tion for the relief of acute and rapidly progressive tym- 
panites. It is performed in 
the left flank, at an equal 
distance between the last 
rib and the angle of the 
haunch, and an inch or two 
beyond the transverse pro- 
cesses of the lumbar region. 

First stage. Incision of 
the skin to the extent of 
about one inch (not abso- 
lutely necessary). 

Second stage. Puncture 
with a sharp trocar directed 
forwards, downwards, and 
inwards. In making this 
puncture the point of the 
trocar is passed through 
the incision, and a sharp 
push is given. The sensa- 
tion of resistance overcome 
indicates that the trocar has 
penetrated the cavity of the 
rumen. Gas then escapes. 
When the operation is com- 
pleted, and the canula is 
being withdrawn, care should 
be taken to press down the^ 

skin on either side with the fingers of the left hand, to prevent acci- 
dental lifting and laceration of the connective tissue. Even so slight 
an accident as this might cause serious complications at a later stage. 

In the absence of a trocar, and in cases of extreme urgenc}^ the 

D.C. 3 B 




Fig. 301. — Trocar for puncture of the rumen. 



7S8 DIGESTIVE APPAEATUS. 

rumen may be directly punctured with a straight bistoury, and 
after the punctured wound is sHghtly enlarged, but before the blade 
of the bistoury is withdrawn, an improvised canula, consisting of a 
hollow elder twig, may be introduced. Were the blade of the bistoury 
withdrawn before the introduction of the canula, the rumen would 
be displaced, and the points punctured would no longer correspond. 

Complications, such as respiratory or circulatory syncope, attacks 
of vertigo, etc., have been noted, but these in reality are very rare* 

Subcutaneous Emphysema. — When the canula is carelessly removed, 
and the subcutaneous connective tissue is torn, local emphysema may 
occur if the ]3ressure of gas in the rumen is very great. This gas 
enters the puncture, proceeds along the connective tissue, particularly 
the subcutaneous connective tissue, and causes crepitant subcutaneous 
emphysema, very easy to recognise. This emphysema may remain 
localised in the neighbourhood of the puncture and gradually become 
absorbed. It may, however, extend to the whole of the flank or even 
beyondj and in exceptional cases bring about generalised subcutaneous 
emphysema. Such very extensive emphysema as this rarely becomes 
reabsorbed without complications. 

The suppuration which follows puncture of the rumen may assume 
one of two forms : — 

{a) That of a little local abscess at the point of puncture, when 
foreign matter or the microbes of suppuration have been left in the 
path made by the withdrawal of the canula. Such abscesses are of 
little importance. They rapidly heal if opened and treated with anti- 
septic injections. 

{h) That of diffuse subcutaneous or interstitial suppuration following 
accidental emphysema. 

The pressure of gas forces fragments of food material between the 
layers of tissue, and suppuration is set up, the pus escaping by a fistula 
at the point of puncture. Such suppuration is decidedly dangerous, 
because it may result in necrosis of the aponeurotic layers of the 
small oblique muscle, in which case recovery is tedious and uncertain. 

Treatment consists in laying open the orifice and fistula, - and 
making a counter opening at the lowest point of the swelling. Free 
drainage and abundant irrigation with boiled water at the body tem- 
perature, followed by antiseptic injections, complete the treatment. 

Peritonitis is not altogether exceptional as a sequel to puncture 
of the rumen, if ordinary precautions are neglected or if infective 
material or fragments of food pass into the peritoneal cavity. 

At first the condition is usually local, but it may extend and assume 
the form of general peritonitis two or three weeks later. The symptoms 
are those of acute peritonitis. 



GASTROTOMY. 



739 



Speaking generally, however, puncture of the rumen in cattle and 
sheep is seldom followed by any complication. 

GASTROTOMY, 

Gastrotomy is performed for the relief of impaction of the rumen 
and to remove foreign bodies, such as linen, nails, bits of leather, etc., 
which have been swallowed. 

A vertical or slightly oblique incision is made in the left flank, 




Fig. 302. — Gastrotomy. P<x, Skin ; Im, 2wz, muscular layers ; Pe, peritoneum ; 
R, rumen, showing line of incision. 

extending from the fourth transverse process of the lumbar vertebrae 
towards the last rib. The operation comprises the following stages : — ■ 

First stage. Incision through the skin for a dis- 
tance of from 6 to 10 inches, according to the size. of 
the animal. 

Second stage. Incision through the muscles and 
peritoneum and torsion of any small muscular arte- 
rioles, which may be divided. 

Third stage. Fixation and immobilisation of the 
rumen with from four to six sutures (Fig. 303). 

Fourth stage. Vertical incision into the rumen ; 
manual examination of the cavity and its contents. 

Formerly the operation was confined to these 
stages. In such cases localised adhesive peritonitis 
follows, causing the rumen to adhere to the internal 
surface of the abdominal wall, and the fistula con- 
tinues in existence for months before complete cicatrisation. It is 
better, therefore, to insert sutures in the rumen, in order to secure, 
more rapid and complete closure. 

Fifth stage. Suture of the rumen with carbolised silk. The lips 

3b 2 




Fig. 303. 



740 



DIGESTIVE APPARATUS. 



of the wound should he hrought together face to face, or they can 

be shghtly inverted, but the sutures should only pass through the 
peritoneum and muscular coats, avoiding the 
mucous coat. If the silk threads pass through 
the mucous membrane and come in contact 
with the gas in the upper zone of the rumen 
they are rapidly macerated, and the sutures 
tear out before the wounds can heaL The 
rumen should always be kept fixed to the ab- 
dominal wall towards the upper and lower ex- 
tremities of the operative wound, in order to 
avoid displacement and occurrence of perito- 
nitis. For a similar reason the passing of the 
silk sutures should be preceded by careful dis- 
infection of the operative wound, and free wash- 
ing of the parts with boiled water. 
The operation is concluded by bringing the skin together with a 

few silk sutures and inserting a strip of iodoform gauze into the 

lower portion of the wound, to serve as a drain. 




Fig. 304. 



LAPAROTOMY* 

Laparotomy is comparatively seldom performed on animals of the 
bovine species, though it may become necessary in dealing with cases 
of hernia, uterine torsion (where direct taxis is called for), Csesarean 
section, invagination or strangulation of the intestine, and under a 
few other exceptional circumstances. 

If simple exploration is aimed at, the operation is most con- 
veniently performed from the right flank with the animal in a stand- 
ing position, but should a prolonged operation be contemplated the 
animal should be cast. The incision varies in length, according to 
circumstances, from 8 to 16 inches, and, like that in gastrotomy, 
should correspond in direction with the fibres of the small oblique 
abdominal muscle; the seat of operation should previously be washed, 
shaved, and disinfected. 

The operation comprises the following stages : — 

First stage. Incision of the skin. 

Second stage. Incision through the muscles and peritoneum. 

Third stage. Exploration, inspection, palpation, extraction or 
ablation, etc. 

Fourth stage. Suture of the peritoneal opening, the lips being 
brought together face to face. 

Fifth stage. Suture of the muscles and the skin. It is some- 
times advisable to insert a drain of iodoform gauze under the skin. 



HERNIA. 



741 



In small animals, sach as the sheep, goat, and pig, laparotomy 
is more easily practicable, and can be performed either in the right 
flank or towards the white line. The stages of operation are exactly 
the same, but after operating near the white line it is extremely 
important to use numerous and strong sutures, and afterwards to 
apply a suspensory bandage around the abdomen, securing it above 
the loins. 

HERNI/E. 

The situation and nature of the hernia determine whether or not 
a radical cure should be attempted. 

When a decision has been arrived at the seat of operation must first 
of all be thoroughly cleansed 
and disinfected. The animal 
is cast in a convenient posi- 
tion, and a general anaesthetic 
is given or a subcutaneous in- 
jection of 1 per cent, cocaine 
solution administered. 

The operation comprises : — 

First stage. Incision through 
the skin covering the hernial 
sac, opposite the orifice of the 
hernia. 

Second stage. Isolation of 
the hernial sac. 

Third stage. Reduction of 
the hernia and breaking down 
of any adhesions that may 
exist. 

Fourth stage. Resection of 
the sac and obliteration of the 
peritoneal orifice by suture and 
ligature. 

Fifth stage. Suturing of 
the muscles and skin, and application of a surgical dressing. 

In practice, the deep sutures should be of bichromatised catgut 
or silk, and the skin sutures of catgut ligature or aseptic silk. 




Fig. 305. — Inguinal hernia in a young pig. 



INGUINAL HERNIA IN YOUNG PIGS. 



One of the most frequent forms of hernia which the practitioner is 
called on to treat is inguinal hernia in young pigs. Although this 
shows little tendency towards strangulation it is always desirable to 



742 DIGESTIVE APPARATUS. 

operate, as otherwise the patients develop badly. There is no diffi- 
culty in this, though the animals must be cast and placed on their 
backs, the hind quarters being raised (Fig. 305). 

First stage. A longer or shorter cutaneous incision over the neck 
of the hernia and along its greater curvature. 

Second stage. Isolation of the hernial sac, consisting of the dilated 
internal sheath. 

Third stage. Direct reduction of the hernia without opening the 
sac, provided no adhesions occur, or, in the event of adhesions, after 
incision of the sac. 

Fourth stage. Torsion of the hernial sac and of the testicular 
cord up to the inguinal ring. Application of a catgut or silk liga- 
ture around the sac and cord at the level of the inguinal ring. 

Fifth stage. Fixation of the ligature to the lips of the ring. 
Suture of the skin wound, and drainage of the wound with a strip 
of iodoform gauze. 

IMPERFORATE ANUS. 

This anomaly of development, which is not uncommon, presents 
two different degrees of development. 

In the first degree the rectum is well formed, and extends as far 
as the skin below the base of the tail. 

In the second the rectum is incomplete or non-existent, the 
floating colon terminating in a blind end at the entrance to the 
pelvis. 

In calves, lambs, and young pigs very often imperforate anus is 
not diagnosed until the second or third day after birth. Defsecation 
cannot occur, and death is inevitable unless an artificial anus be 
established. 

First Degree.— The patient loses appetite, the abdomen remains 
distended, and on examination of the anal region a doughy swelling 
is felt, which projects backwards when the animal strains. The 
operation is quite elementary, and always proves successful. 

First stage. The skin beneath the tail is incised vertically; the 
rectal cul-de-sac projects towards the incision. 

Second stage. The rectal cul-de-sac is punctured, the contents 
are removed, and the rectum and skin united by a few sutures. An 
anus is thus established, though there is no sphincter. 

Second Degree. — The general symptoms are similar, though very 
often the little patient shows symptoms of atrophy or arrest in 
development. The operation is somewhat complicated. 

First stage. Vertical incision through the skin at the base of 
the tail. 



PROLAPSUS AND INVERSION OF THE RECTUM. 



743 



Second stage. Digital exploration of the cavity of the pelvis 
after breaking down of the layers of connective tissue, and search 
for the blind end of the floating colon. When discovered, the colon 
is grasped between the jaws of a clamp or large forceps with smooth 
jaws, and gently drawn 
towards the opening. 

Third stage. Punc- 
ture of the blind end of 
the colon, and suture of 
the latter to the cutaneous 
wound, as in the former 
case. 

A third condition may 
exist, where the ex- 
tremity of the colon re- 
mains within the abdo- 
men. Operation by way 
of the pelvis then proves 
unsuccessful. If con- 
sidered advisable, an 
opening may be made 
through the right flank, 
so that the floating colon 
may be brought to the 
surface and an artificial 
anus produced in this 
region. 

An incision 1 or 2 
inches in length is made 
below^ the haunch, to 
allow of the introduc- 
tion of the index finger, 




Fig. 306.— 1, Prolapse of the rectum and vagina ; 
2, schema showing the relations of the layers of 
the rectmii in prolapse ; 3, first phase, showing 
manner of fixing the superposed layers of tissue 
by insertmg four sutures— the left index finger is 
inserted into the rectum in order to manipulate 
the parts ; 4, mterrupted sutures inserted around 
the bowel after amputation. 



W^ith w^hich the loop is 

sought. The colon is withdrawal, and the operation thenceforth is ^s 

above described. 



PROLAPSUS AND INVERSION OF THE RECTUM. 

This condition occurs in young pigs in various degrees. The 
necessity for reduction depends on the extent to w^hich tearing or 
gangrene of the mucous membrane has progressed. The inverted 
portion is carefully washed, freely dressed with some non=irritant 
fatty substance such as vaseline, and progressively pushed back with 
the thumbs and index fingers of both hands applied flat on either 



744 DIGESTIVE APPARATUS. 

side of the anus. To facilitate reduction it is best to check the 
animal's expulsive efforts by placing a gag in the mouth. 

In more aggravated cases, when prolapsus of the rectum has 
returned several times and the mucous membrane is gangrenous in 
places so that such a complication as peritonitis of the pelvic cavity 
is to be feared, it is better to amputate the prolapsed portion. 

The animal is secured either standing or lying down, and a large 
enema is administered to remove the contents of the rectum. The 
herniated portion of bowel is carefully examined, for it sometimes 
happens that loops of intestine have become lodged in the dilated 
peritoneal sac, produced by displacement of the rectum. In such 
cases reduction should be effected before anything more is done, and 
for this purpose the patient's hind quarters should be* lifted or even 
suspended. 

The operation for removal comprises two stages : 

(1.) Fixation of the two layers of bowel by the passage of either 
two or four sutures about J an inch behind the anus. 

(2.) Circular amputation of the sutured tissues ; insertion of inter- 
rupted silk sutures through the lips of the wound ; reduction. The 
patient is restricted to milk diet* for a week. Laxative gruels, etc., 
may then be given. 

The complication to be feared is peritonitis of the pelvic cavity 
owing to the sutures tearing out and allowing infective material to 
pass from the bowel into the cavity. 

Slight cases of prolapsus might possibly be treated by the injection 
in lines of melted paraffin wax beneath the mucous membrane of the 
last part of the bowel. The injection is made by means of a large 
syringe provided with a long needle, the needle being gradually with- 
drawn as the melted wax is expressed. Four " pillars " of wax are 
usually injected at equidistant points. As they solidify they support 
the bowel and prevent the recurrence of the prolapse. The operation, 
however, is delicate, and scarcely to be recommended in pigs. More- 
over, in man, in whom it has chiefly been practised, the deferred results 
have not always proved satisfactory. 



CHAPTER V. 
RESPIRATORY APPARATUS. 

TREPHINING THE FACIAL SINUSES. 

This operation is necessary when pus, tumours, or parasites exist 
within the sinuses, and in some cases where tumours form within 
the nasal cavities, etc. 

TREPHINING THE HOEN CORE. 

This cavity is opened in front, at the base of the horn, about 
I of an inch above the keratogenous band. 

FRONTAL SINUS. 

The frontal sinus may be trephined at one of two points, that is, 
either towards its highest or lowest extremity. 

In the former case the point selected is in the direction of the 
axis of the horn core, about | of an inch nearer the middle line than 
the base of the horn itself. 

The animal should be cast. 

First stage. A V-shaped incision | of an inch long on each side 
is made through the skin and subjacent tissues, exposing the bone. 

Second stage. The skin and periosteum are dissected away and 
reflected upwards. 

Third stage. Trepanation. 

The lower portion of the cavity is trephined within the angle 
formed by a transverse line uniting the upper margin of the orbits 
and the inner margin of the super-orbital foramen. 

The stages are precisely the same as those above described. 

MAXILLARY SINUS. 

In adult animals the maxillary sinus is opened immediately above 
the maxillary tuberosity. In the young the point selected is f of an 
inch higher. 



746 RESPIRATORY APPARATUS. 



TRACHEOTOMY. 

In bovine animals tracheotomy is only performed in urgent cases, 
in order to ward off asphyxia or to facilitate some other operation 
on the upper air passages. It is performed exactly as in the horse, 
the animal either standing or lying down. In the former case, the 
animal may be placed in the trevis, but two strong assistants hold- 
ing the animal's head and nose by means of "bulldogs" are often 
sufficient. 

To prevent the animal from striking out with the front legs, a 
rope is passed above and around the knees in the form of the figure 
8 ; the animal is backed into a corner, and operation is then quite 
safe. 

Large animals must be cast or placed in the trevis. 

The seat of operation should be washed, shaved, and disinfected. 

The operation may be divided into four stages. 

First stage. Vertical median incision about 2 inches long 
through the skin at the height of the upper third of the trachea. 

Second stage. Separation with a blunt director of the muscles 
covering the trachea. Incision through the pretracheal connective 
tissue. 

Third stage. Circular or elliptical opening through the trachea 
of a size corresponding to that of the tracheotomy tube. 

Fourth stage. Insertion of the tracheotomy tube. 



CHAPTER VI. 
GENITOURINARY ORGANS. 

In the domestic ruminants the penis exhibits a peculiar S-shaped 
curve, situated in the sub-pubic region (Fig. 226), so that when 
operation on the urethra, or even on the extremity of the penis, 
becomes necessary the organ must first of all be withdrawn. 

The manipulation is as follows : — 

The animal having been fixed by the head and front legs in a 
standing position, and if possible thrust against a wall, the operator 
stands on its left side. With his right hand he seizes the penis 
and the skin immediately in front of the scrotum and pushes them 
forward in the direction of the opening of the sheath. 

The extremity is nipped between the first fingers of the left hand, 
and to prevent the glans slipping or escaping when the right hand 
is removed (for the purpose of taking a fresh hold of the body of 
the penis further back) the operator may reverse the free extremity 
of the penis so that it forms a loop, and thus secure a firmer hold. 
With the right hand the skin is thrust backward, a new portion 
of the sheath fixed, and the organ again pushed forward. In this 
way the penis is gradually extended. W'hen the animal is cast, this 
manipulation is much easier. 

URETHROTOMY IN THE OX. 

Urethrotomy consists in incising the urethra, usually for the pur- 
pose of extracting a foreign body or calculus which impedes micturi- 
tion. In the ox, calculi may become fixed either in the intra-pelvic 
portion of the urethra, though this is very rare ; in the ischial 
curvature, or more commonly at some point in the S-shaped curve 
of the penis ; or sometimes even within the sheath itself. 

Urethrotomy is performed in the ischial or scrotal region, accord- 
ing to the point where the obstruction exists. 

ISCHIAL UEETHEOTOMY. 

Urethrotomy is performed in the ischial region either to displace 
or indirectly to abstract a foreign body fixed in the membranous 



748 GENITO-URINABY ORGANS. 

portion of the urethra, or dkectly to remove one from the spongy 
portion opposite the ischial curve. 

Calculi fixed in the intra-pelvic region are detected by rectal 
exploration. 

The exact position of the foreign body is determined by inspec- 
tion and palpation, whilst distension of the urethra by urine may 
be noted even before more striking symptoms appear. 

The urethra can be incised by one of three methods. 

The animal should be secured, if possible, in the standing 
position. 

The first method, which dates back to very early times, consists 
in puncturing the urethra at one stroke with the fleam or lancet, 
and opening it more freely, after introducing a grooved director. 
This method is very useful where rupture of the bladder is 
imminent. 

The extraction of a calculus fixed in the ischial region, or the 
manipulation of an obstruction at any other point, can afterwards 
be undertaken. 

Second method. A second method consists in incising the sub- 
cutaneous tissues, layer by layer, until the urethra is reached at 
the ischial arch. 

The operation is terminated by puncturing the urethra and 
enlarging the incision in an upward direction after passing a grooved 
director. This method minimises hsemorrhage and urinary infiltra- 
tion. By previously injecting cocaine, the operation may be made 
practically painless. 

Third method. Puncture of the urethra by a single stroke v/ith 
a straight bistoury at the ischial arch. 

The opening is enlarged in an upward direction with the same 
instrument. 

SCROTAL URETHROTOMY. 

Scrotal urethrotomy is necessary when the calculus is situated 
in one of the S-shaped curves of the penis or nearer the glans. 

The operation is facilitated by casting the animal and with- 
drawing the penis from the sheath, but as therfe is considerable 
danger of rupturing the bladder when casting an animal with 
marked distension of that organ, the more serious operation should be 
preceded by puncturing the urethra with a fleam at the ischial arch. 

By repeated moderate traction on the extremity of the glans, the 
S-shaped curve can be obliterated and the anterior portion of the 
penis withdrawn beyond the sheath. 

One of two conditions may exist. 



PASSAGE OF THE CATHETER AND URETHROTOMY IN THE RAM. 749 

First case. Where the calcukis is in the anterior, extra-prepubic 
portion, it is removed through an incision made directly over it. 
After extraction and disinfection, one or two sutures are inserted. 

Second case. Should the calculus be situated in that portion of 
the penis which remains within the sheath after the fullest with- 
drawal of the organ, it is necessary to proceed as follows : — • 

(1.) The skin covering the sheath, the subcutaneous tissue, and 
the mucous membrane are first incised for a length of from IJ to 
If inches. 

(2.) The penis is drawn through this opening; an incision is made 
directly over the calculus, dividing the fibrous layer, erectile tissue 
and mucous membrane of the urethra ; the parts are disinfected and 
the wounds closed with sutures. 

With ordinary antiseptic precautions little danger is to be feared. 

Even should infiltration of urine occur, the operator need not be 
unduly anxious, for, provided the parts are punctured or scarified 
early, recovery usually follows. 

PASSAGE OF THE CATHETER AND URETHROTOMY IN 

THE RAM. 

Obstruction of the urethra in rams is more commonly caused by 
deposits of gravel than by single large calculi. It is generally found 
in highly-fed animals, in which gravel accumulates and becomes 
massed together at some point in the canal, often near the free 
extremity, w^here it forms a plug, causing complete retention of urine. 
In other cases this retention is due to a mass of sediment formed 
by vesical mucus and fine gravel which collects about the neck of 
the bladder. 

Three operations have been advised for the removal of this con- 
dition : — 

(1.) Section of the Appendix of the Penis. — When the disease is 
just appearing the sedimentary material may be collected at the 
anterior extremity of the penis behind the appendix. The shepherds 
in such cases remove the extremity of the penis. The resistance 
disappears, the plug formed of gravel yields to the pressure of urine, 
and micturition occurs as usual. Excision of the appendix, how'ever, 
incapacitates the ram for service. 

(2.) Passage of the Catheter. — Passage of the catheter has been 
recommended for the removal of deposits of gravel in the urethra, 
but it seems a very questionable method. 

Should it be determined on, the animal must be placed on its 
back. The penis is then withdrawn and the double S-shaped curve 
is obliterated. An incision is made over the canal behind the 



VoO 



GENITO-URINARY ORGANS. 



appendix and a soft gutta-percha sound is passed. The sabulous 
accumulation is thus dispersed. 

(3.) Urethrotomy. — Scrotal urethrotomy may be performed as in 
the ox.' 

Ischial urethrotomy is impracticable in very fat animals, but when 




Fig. 307. — Passing the catheter in the cow. 

the obstruction is about the neck of the bladder, and the animal's 
condition admits of it, this operation may be performed. 

The patient is fixed on its back, and a metallic or gutta-percha 
sound is passed into the urethra. The tissues are incised layer by 
layer in the direction of the sound. Once the urethra has been 



^ 



Fig. 308. — Catheter for cows. 



opened the soft magma may be washed out of the bladder by a free 
injection of boiled water or similar aseptic liquid. 



PASSAGE OF THE CATHETER IN THE COW, 

It sometimes becomes necessary to examine the bladder of the cow. 

There is an obstacle, however, to the introduction of the sound 
into the urethral canal. The meatus urinarius is covered by a little 
valve which springs from the lower wall and forms behind the real 
opening of the urethra a cul-de-sac, into which the point of the 
catheter is apt to pass. The instrument usually employed is of 
gutta-percha, glass, or, better still, of metal, as more easily sterilised 
(Fig. 308). It is held like a pen, and is directed along the floor of 



CASTRATION. 751 

the vagina as far as the opening of the meatus, being guided by the 
index finger of the left hand, which has previously been introduced. 
The point being very slightly depressed, it enters the cul-de-sac. It 
is then only necessary to reverse the movement, that is to say, raise 
the point, whilst gently pressing forward ; a slight resistance is felt 
and the sound enters the blad'der. If necessary the little valve may 
be held down by gently pressing on it with the point of the left 
index finger. 

It is sometimes an advantage to expose the seat of operation. In 
such cases the lips of the vulva and the walls of the vagina may 
be separated by retractors or by the use of a speculum. 

CASTRATION. 

Castration is performed for the purpose of removing the repro- 
ductive power, either by obliterating the testicle or ovary or by 
suppressing their functions. 

In ruminants, the testicles are elongated and placed in a vertical 
position, the upper portion of the scrotum presenting a constriction 
and the whole scrotal mass resembling in shape a cone with its base 
downwards. 

CASTEATION OF THE BULL AND RAM. 

These two animals, when destined for slaughter, are usually 
castrated either at birth or at latest two or three months afterwards. 
In Normandy, in Franche-Comte, and in England breeders castrate 
young bulls by torsion of the cord. 

Two incisions about IJ to If inches in length are made on the 
lower extremity of the scrotum. The testicles are enucleated and 
the testicular cords seized with two pressure clamps, with which 
torsion is. effected. In the South of France, in Auvergne, and in the 
Limousin, bulls intended for working are not castrated until after the 
lapse of some months, on account of the influence w^hich the testicles 
have on the development of the bones and muscles. Such animals 
are only operated on at the age of from six months to a year, and 
as a rule the method employed is that of bistournage. 

. BISTOURNAGE. 

This method of castration has been practised from time im- 
memorial. It consists essentially of torsion of the testicular cord, 
and aims at obliterating the vessels which it contg^ins, and thus 
bringing about atrophy of the organs served by them. 

The Bull. — The animal is operated on in the standing position. 
The head is fixed to a post or ring somewhat high up, in order to 



752 



GENITO-URINARY ORGANS. 




509. — Bistournage. First phase. Manipulating 
the scrotum. 



check movement of the hind legs. The hind legs are also partially 

secured by means of 
ropes or two pieces 
of webbing passed in 
a running noose about 
the hocks and fixed 
above the knee. No 
preliminary disinfec- 
tion is practised, be- 
cause no wound is 
made. 

Manual Technique. 
The operation com- 
prises four stages : 

First stage. The 
operator, standing be- 
hind the animal's hocks, grasps the testicular cords with the hands, 
immediately above the testicles, and by exercising strong pressure, 
thrusts the latter to the extreme 
base of the scrotum. The move- 
ment is next reversed ; seizing the 
base of the scrotum with the right 
hand, he draws it smartly down- 
wards, whilst he places the left 
hand above the right, and thrusts 
the testicles towards the abdomen. If 
the testicles do not rise sufficiently 
high, the right hand is slipped 
between these and the left hand, 
and the testicles are thus thrust up- 
wards towards the lower inguinal 
rings, slightly dilating the latter. 

After this manipulation has been 
repeated two or three times, the 
scrotum, etc., become more pliable 
and the testicles more easily dis- 
placed. The second stage of the 
operation is thus facilitated. 

Second stage. The second stage 
of operation may be effected by one 
of two methods. 

Old method: The oldest method 
consists in allowing one of the testicles to rise towards the inguinal 




Fig. 310. — Bistournage. First phase. 
Thrusting the testicles upwards; 
manipulating the scrotum. 



CASTRATION. 



753 



ring and to turn the other in a vertical plane. If, for instance, it 
is desired to turn the right testicle, the cord is grasped between the 






Fig. 311. — Bistournage. Second phase. 



thumb and index finger of the left hand (Fig. 311), the lower part 
of the scrotum is seized with the right hand, and the object then 
is to slide the point of the testicle along the dorsal surface of the 
D.c. • 3 c 



754 



GENITO-URINAKY ORGANS. 



fingers (Fig. 311). Simultaneously the operator presses on the base 
of the testicle with the thumb of the left hand, thus causing a rotary 
movement in a vertical plane ; the tail of the epididymis becomes 
uppermost. A certain empty space separates the testicle from the 
base of the scrotum. 

Third stage. Torsion of the cord. The testicle having been 
rotated, the cord must be twisted so that the vessels may be oblite- 
rated. The left hand continues grasping the cord, which is then 
brought in front of the testicle, whilst with the right hand the testicle 
is pushed backwards and is made to describe a semi-circle. The cord 
was previously on the left side ; it is now on the right, and simul- 
taneously the testicle passes from right to left. 

In completing the turn the 
hands must not be changed, and, 
above all, must not let go their 
hold ; and the cord is pushed for- 
wards and toNvards the right with 
the right hand, whilst the testicle 
is pushed backwards and to the 
left with the left hand. The cord 
and the testicle resume their ori- 
ginal position ; one complete turn 
has been effected. These manipu- 
lations are repeated several times, 
and the cord soon assumes the 
appearance of a large, hard, tense 
string. To ensure obliteration seven 
or eight turns should be made in 
the case of the bull and four or 
five in that of the ram. 

Torsion of the right testicle 
being complete, the gland is thrust towards the upper part of the 
scrotum and the left testicle is submitted to the same manipulation, 
the position of the hands, however, being reversed. 

Fourth stage. Fixation of the testicles in the inguinal region. 
Both testicles having been thrust upwards as far as possible into 
the inguinal region, the scrotum is ligatured below them. Tape or 
thick cord should be used, to guard against gangrene of the lower 
portions of the scrotum. A considerable oedematous swelling soon 
occurs, and when at the end of twenty-four or forty-eight hours 
infiltration is well developed, the ligature should be removed. 

Dubourdieu has described a different method, in which the testicle 
is rotated in a horizontal plane. The position of the hands is 




Fig. 312. — Bistournage. Third phase. 



CASTRATION. 



/OO 




Fig. 313. — Bistournage. Second phase. 
Dubourdien's method. 



then different. The left testicle, for instance, being at the base 
of the scrotum, the cord is 
grasped with the right hand 
opposite the base of the tes- 
ticle, and the tail of the epi- 
didj^mis and the testicle are 
held with the whole hand 
whilst being rotated. If care 
is taken to fix the cord with 
the right hand, rotation is 
more rapid and easier than 
in the preceding method. 

DiflBculties in Operation. 
— Bistonrnage is highlj^ com- 
mended in France on account 
of its avoiding all the com- 
plications resulting from 
sanguinary operations. Never- 
theless it presents great diffi- 
culties, particularly in bulls of 

from two to three years of age, in which the testicles are hard to 
manipulate on account of their size, the thickness of the connective 

tissue, and sometimes because 
of abnormal adhesions. In 
such cases the preliminary 
manipulation alone some- 
times extends over half an 
hour. 

Bistonrnage is of doubt- 
ful efficacy when the testicles 
are small and round, because 
after the ligature has been 
applied the testicular cord 
tends to untwist, and the 
shape of the testicles readily 
lends itself to such move- 
ments. If untwisting occurs, 
the operation fails. 

Consequences of the Opera- 
tion. — The operation is often 
followed by more or less vio- 
lent attacks of colic ; the 
animal may suffer for five or six hours, after which it recovers. 

3 c 2 




Fig. 314. — Bistournage. Second phase. 
Dubourdieu's method. 



756 GENITO- URINARY ORGANS. 

If torsion has been clumsily performed, or if the ligature be- 
comes displaced, the testicle may descend and the cords untwist ; 
the latter then appear to have lost the firm, tense consistence 
which they presented after operation. To prevent slipping of the 
ligature and untwisting of the cord, Guittard suggests the use 
of an iron needle, with which the scrotum is pierced through 
the median line, just beneath the testicles when at their highest 
position ; above this is placed the ligature, which then cannot 
possibly slip. 

The Basque operators, in order to avoid untwisting, exercise 
vigorous traction from above downwards after rotating the testicle. 
In this way ruptures occur which diminish the elasticity of the 
cord and the epididymis, and tend to check the untwisting of the 
former. 

When the operation has succeeded the testicles gradually atrophy. 
They do not disappear completely, and may sometimes be found several 
years later of the size of a hazel-nut or a chestnut and of fibrous con- 
sistence. It need scarcely be said that in the event of bistournage 
failing, cutting operations can always be resorted to. 



MARTELAGE. 

The process of martelage consists in mutilating with a mallet the 
testicular cord whilst still covered by all its envelopes. This mutila- 
tion injures the walls of the arteries, causing the formation of a clot, 
which cuts off the supply of blood to the testicle and causes the 
gland to atrophy. 

The practice is very ancient. 

The animal is fixed by the horns as if for bistournage, and 
the limbs are secured by two strips of webbing or two ropes, as 
in the former case, though some practitioners neglect the latter 
precaution. 

Two cylindrical rods the size of broomsticks and a wooden mallet 
or farrier's hammer are the instruments employed. 

The method, however, is barbarous, cruel, and of doubtful value. 
It would never be countenanced in England. 



CASTRATION BY CLAMS. 

Castration of bulls by means of clams has been practised in many 
different forms. 



CASTRATION. 



757 



Castration by the Exposed Method. — The operation is the same 
as in the horse, the scrotum being incised on either side, and the 
dartos, connective tissue, tunica vaginahs scroti, and tunica 
vaginaUs testis being divided. Short clams are appHed to the 
cord, and the himen of the arteries is completely oblite- 
rated in five to six 
days, when the 
clams can be 
removed. 

Instead of an in- 
cision being made 
for the removal of 
each testicle, the 
scrotum and dartos 
may be divided in 
the middle line, after 
which incisions may 
be made to the right 
and left respectively, 
exposing the fibrous 
tissue and enabling 
the testicles to be 
enucleated. A clam 
may then be applied 
to each cord, or the 
two cords may be in- 
cluded in one pair 
of clams. 

This method has the advantage of inflicting less injury on the 
scrotum, a point which is of some importance in animals destined for 
slaughter. 

Castration by the Covered Method. — This operation is identical 
with the preceding, except that the incision of the scrotum does 
not involve the cremaster and fibrous tunic, or the tunica vaginalis 
scroti. 




Fig. 315. — Crushing the testicular cord, (This method 
is to be strongly condemned.) 



CASTRATION BY TORSION. 

The cord may be twisted throughout its entire length or torsion 
may be limited to a part of the cord, hence the two methods here- 
after described. 

(a) Limited Torsion. — -The testicles are exposed as in castration 
by the open method. The cord is then drawn forward and fixed by 



^58 



GENITO-URINARY ORGANS. 



means of forceps applied just outside the scrotum ; | to 1 inch below 
this point the torsion forceps are appHed. The cord is slowly 
twisted, and usually ruptures about the centre of the fragment in- 
cluded between the two pairs of forceps. 

(b) Direct or Unlimited Torsion. — First stage. The testicle is ex- 
posed, as in castration 
by the covered method. 
Second stage. The 
cord and vaginal tunic 
are twisted by grasp- 
ing the testicle, which 
is protected with a 
piece of clean linen. 

CASrRATION WITH THE 
ACTUAL CAUTERY. 

The testicles are 
exposed, the cords are 
seized with clams and 
divided separately or 
together with a sharp- 
bladed cautery at a 
white heat. The es- 
char so produced is 
sufficiently dense to 
obliterate the vessels. 

\ CASTRATION BY THE 

ELASTIC LIGATURE. 

This method has 
been largely employed 
during the last ten 
or fifteen years. It 
consists in applying to the upper part of the scrotum several turns 
of a tensely stretched round or square rubber thread. The two 
ends of the rubber thread are crossed and tied with string. About 
the seventh or eighth day the testicles may be removed with a 
knife close to the ligature, provided the process of delimitation is 
well advanced. 

The chief objection to this method lies in the fact that the 
scrotum is destroyed, which lowers the value of the animal from 
a commercial point of view. 




CJICOiET 



Fig. 816. — Castrating the ram by ligature. (This 
method is to be strongly condemned.) 



CASTRATION. 



759 



CASTRATION OF THE RAM. 

Most of the preceding methods may be used in castrating rams, 
but certain special methods are more generall}^ employed. These we 
shall shortly mention. 

Castration by Bistournage. — The method is exactly similar to that 
in the bull. The animals are placed in the position shown in the 
figure, except that the hind limbs are extended and held in that 
position by the operator's knees or feet. The process is only applic- 
able to animals of four or five months old. 

Castration by Tearing. — This method is only practised by shep- 
herds, and on animals a few days or at most a month old. The 
base of the scrotum is snipped off with scissors, the testicles are 




Fig. 317. — Castration of 



young pigs. 



enucleated, and each in turn is seized and torn away with a sudden 
snatch. Even though a considerable length of cord is removed with 
the testicle, bad results seldom follow, provided the subject is not 
of greater age than that mentioned. 

Castration by Ligature. — This method consists in passing a stout 
ligature in the form of a running knot over the neck of the scrotum 
and, by means of two short pieces of wood, drawing it tight. The 
method, however, is not to be recommended, as it not infrequently 
leads to tetanus. 



CASTRATION OF BOARS AND YOUNG PIGS. 

For castration boars should be cast on the left side, and three 
legs at least firmly secured together (Fig. 317). The best method is 

Care should be taken to avoid dragging the 



that of limited torsion, 



760 GENITO-URINARY ORGANS. 

cord downwards during the operation, for the testicular artery rup- 
tures readily, and fatal abdominal hEemorrhage may follow. 

As the subjects are apt to wallow in the litter after the opera- 
tion a strip of iodoform gauze should be applied and secured by 
one or two sutures. This is removed on the third or fourth day. 

On young pigs the operation is simpler. The animal is cast on 
the left side and firmly held, the left hind limb being extended and 
the right drawn towards the right shoulder. 

The testicles are grasped each in turn with the left hand, whilst 
with the right they are exposed by a single sweep of the bistoury. 
The testicles are removed by torsion with artery forceps. Many lay- 
men simply use the hands, the cord being grasped between the left 
thumb and index finger, whilst torsion is effected by the right index 
finger thrust between the vas deferens and the body of the testicle. 

CASTRATION OF CRYPTORCHIDS. 

Cryptorchids are very rare amongst cattle and sheep, as the 
testicles enter the scrotum during intra-uterine life. The internal 
inguinal ring in the pig being of very small size, the condition 
is more common in that animal. 

The same process is employed in castrating cryptorchid bulls, 
rams, or boars. The animal is thrown on one side and securely 
fixed. A vertical incision is made in the region of the flank, vary- 
ing in length from 4 to 5 inches in the bull, 2 to 2|- inches in 
the ram, and 4 to 5 inches in the pig. The abdominal cavity is 
examined, the testicle found, and a ligature applied to the cord, after 
which the testicle is removed. 

Another method consists in employing the ecraseur for division 
of the cord. 

To avoid subsequent complications antiseptic precautions should be 
taken. 

Complications after Castration. — Whatever the method employed, 
swelling of a more or less abundant character always develops during 
the few days immediately succeeding the operation. It is, however, 
of little importance. 

Should antiseptic precautions be neglected, suppuration, septi- 
caemia, tetanus, and sometimes scirrhous cord may follow. 

FEMALE GENITAL ORGANS. 

Examination with the Speculum. — In the cow certain diseases 
of the vagina, bladder, neck of the uterus, and even of the uterus 
itself, may necessitate visual examination in addition to the manual 



CASTRATION. 



761 



examination commonly employed. Under such circumstances a special 
speculum is introduced in a closed condition, being afterwards opened 
and dilated to the required extent. 

Before inserting the specuhmi, however, the genital passages should 
be cleaned, and the speculum itself smeared with vaseline. It pene- 
trates readily with moderate pressure. 

Heifers and similar animals require a special (small) instrument 
(Fig. 318). 

In certain circumstances, moreover, it is preferable to use retractors, 
with which local examination is easier. These can be applied at either 
side of the vagina and drawn apart, thus ex- 
posing the depths of the genital tract. 



CASTRATION OF THE COW. 

The operation of castrating the cow is 
very old, and was mentioned by both Aristotle 
and Pliny. Many other descriptions of it 
have since been given. But more recently 
the manual technique has been considerably 
simplified and very fully described. 

Utility. — The operation is practised for 
the cure of nympho-mania ; also to prolong 
the period of milk-yielding and to facilitate 
fattening. 

As regards nympho-mania, it is only of 
value where the excessive excitement is due 
to disease of the ovaries. 

Under ordinary conditions the secretion of 
milk diminishes more or less, and becomes 
very slight after eight or nine months from 
calving. If, however, the cow is castrated 
under favourable circumstances, lactation con- 
tinues for several months, sometimes for several years, beyond this 
period. It is said that castrated cows yield milk of a more constant 
composition and richer in butter fat, casein, and mineral salts than 
those which are not castrated, although the point cannot be said to have 
been fully established. 

To obtain the best results the subjects should have attained their 
maximum yield of milk and be from five to seven years old. The best 
period is six weeks to two and a half months after calving. Neglect of 
these considerations is liable to be followed by inappreciable, doubtful, 
or bad results. 




Fig. 318. — Vaginal speculum 
for heifers. 



762 



GENITO-URINARY ORGANS. 



The influence of castration on fattening is explained by the suppres- 
sion of oestrum. 

Manual Technique.— An ovariotome with a hidden blade and an 
ecraseur with an extra long stem are the only instruments required. 
The animals should be prepared for some days by diminishing their 
food supply and administering gentle laxatives. 

Acute or chronic lesions of the genital tract should be held to 
contra-mdicate operation, and it should be noted that tuberculous 
animals are particularly liable to awkward complications. 

On the day of operation an abundant enema is given, to empty the 
rectum, after which the vagina is washed out freely with a lukewarm 
solution of some non-irritant antiseptic. The hind quarters, and par- 
ticularly the neighbourhood of the anus, vulva, base of the tail, etc., 
should be carefully washed and disinfected with a solution of 'lysol! 
cresyl or carbolic acid. 

The patients are secured in a standing position, a rope being 
passed in the form of the figure 8 around the hind limbs above the 




Fig. 319.— Ovariotome. 

hocks, and the animal is then firmly thrust against a wall by several 
strong assistants. 

The operator's hands and instruments must be rigorously disinfected. 

The operation comprises three stages : 

First stage. Puncture of the vagina. 

Second stage. Finding and securing the ovaries. 

Third stage. Ablation. 

The hand is smeared with sterihsed oil, and, grasping the ovario- 
tome, is passed into the vagina, which contracts on it and on the fore- 
arm. Within a short time, however, which may vary between two or 
three minutes and a quarter of an hour, the vagina becomes distended 
and its walls rigid, so that the operator is able to continue his manipu- 
lations more easily. This is the moment for effecting puncture, after 
an examination of the pelvic organs through the vaginal walls. 

^ The blade of the ovariotome is advanced until fully exposed, and the 
point is brought directly above the neck of the uterus, about | to 1\ 
inches from it. By a sharp movement the instrument is then thrust 
directly forward, dividing the wall of the vagina in the median line. 



r 



CASTRATION. 



76^ 



The blade is next retracted into its sheath and the instrument 
dropped on to the floor of the vagina. The right index finger is at once 
passed through the orifice so made into the peritoneal cavity, in order 
to make certain that all the membranes have been divided. By pressing 
on and slightly tearing the tissues the middle finger is then introduced 
alongside the index. Only these two fingers should be passed into the 
peritoneal cavity. 

In order to secure the ovaries it then suffices (Fig. 321) to thrust 
forward the base of 
the vagina, allowing 
the two fingers to 
glide over the body 
of the uterus and 
thence downward 
over its side to the 
point Avhere the 
horns of the uterus 
originate. Here the 
fingers meet the 
ovary,which is readily 
recognisable on ac- 
count of its size and 
shape (those of a 
w^alnut). The gland 
is nipped between the 
index and middle 
fingers, and is drawn 
into the vagina 
through the opera- 
tive opening. 

In order to re- 
move the ovary the 
operator seizes the 
ecraseur with the 

left hand, a loop of chain about an inch long projecting, and slides 
the instrument along his right forearm. The arm must be retained 
in the vagina, the fingers grasping the ovary. The organ is slipped 
into the loop of the ecraseur, w4iich is then manipulated with the left 
hand until the pedicle is divided. To prevent haemorrhage the screw 
of the ecraseur should only be turned at the rate of about twice a 
minute. The ovary when separated is left on the floor of the vagina, 
the fingers being again introduced into the abdominal cavity to secure 
the second one. This is removed in precisely the same w^ay. 




Fig. 320. — Castration of the cow. First phase. 



764 



OENITO-URINARY ORGANS. 



with, the !.,/;„, the t:rttL r'Trs'Ttir^' 't^^ 

m« come together again spontaneously as tL vliL eonf" '" 

This operation is followed by slight colic which l! '""'^'^°^^- 

cause alarm ^ ' ^'^"''^' ^^o^ever, need not 

portion of the aorta or 
the iliac arteries. The 
blood then streams 
past the operator's 
hand, and the animal 
dies of internal 
haemorrhage in a few 
minutes; nothing can 
be done. 

If there is undue 
haste in manijDulating 
the ecrasenr, the 
pedicle of the ovary 
is cut rather than 
crushed, the vessels 
close imperfectly, and 
grave hemorrhage 
may occur. 

In cases where 
haBmorrhage is slight 
the peritoneal clot is 
readily re - absorbed ; 
but should the animal 
happen to be tuber- 

frequently. ^^'' '""''°"' ''''' "^^^e, it occurred rather 

Pelvic peritonei, fol^- ^ "'°''"' °* ^"^^^^P'''^ precautions, 

acute piSw \ T^ ^" .operation is indicated, like ordinary 
ute peritonitis, by loss of appetite, peritonism, colic, etc 




Fig. 821.-Castration of the cow. Second phase. 



CASTRATION. 765 

Even where peritonitis is avoided a local abscess often forms in 
the vaginal wall owing to infection of the operation wound. The 
symptoms are delayed for several days, sometimes for a fortnight 
after operation, and consist in straining efforts, moderate peritonism, 
diminution in appetite, etc. Vaginal or rectal examination reveals 
the character and extent of the disease. The abscess should be 
punctured through the vagina. 

Finally, it may happen that castration does not prevent the 
recurrence of oestrum. The ovarian pedicle may have been divided 
too close to the glandular tissue, a fragment of which has remained 
adherent to the pedicle. 

Certain other operative complications are also possible in dealing 
with cows suffering from nympho-mania which have developed cysts, 
tumours, or abscesses of the ovaries. It is then necessary to enlarge 
the incision in the vagina and take particular precautions not to 
rupture the cysts or abscesses in the peritoneal cavity. The operator 
must proceed cautiously and modify his technique according to cir- 
cumstances. 

CASTRATION OF THE SOW. 

Castration of the sow has been practised since very ancient 
times. The operation is performed on animals intended for fatten- 
ing, and at all ages between six w^eeks and maturity. 

Anatomical Arrangement of the Genital Organs. — Before perform- 
ing ovariotomy in the sow it is indispensable to understand the special 
arrangement of the genital organs. The uterine horns are very long 
and folded on themselves, forming convolutions which give them 
somewhat the appearance of small loops of intestine. Nevertheless 
they can readily be distinguished by the touch, for they are much 
smaller in size than the latter. 

In young sows, two to three months old, they are of about the 
thickness of a small pencil. Differentiation is more difficult in 
sows that have borne litters, but as the ovaries alone are withdrawn, 
leaving the horns of the uterus uninjured, this distinction is unim- 
portant. 

The horns of the uterus are suspended in the peritoneal cavity 
by means of very extensive, well-developed, and very lax ligaments, 
and, as the horns of the uterus lie at a very acute angle one to the 
other, the ovaries are very close to the median line of the abdo- 
men. The length and yielding character of the parts and the close 
apposition of the ovaries explain why the latter can be found and ex- 
tracted through a single incision in the flank, either on the right or 
left side. 



766 



GENITO-URINARY ORGANS. 



An ordinary convex bistoury or a special knife and two artery 
forceps are the instruments employed. 

Manual Technique. — The animal is cast on the right or left side, 
preferably on the right, so that the right index finger can be employed. 
Full-grown sows should always be muzzled. In the case of young- 
animals, the limbs should be grasped by assistants, the hind limbs 
being crossed one over the other and drawn backwards. 

Antiseptic applications are highly desirable, although they are 
usually neglected when a layman directs the operation. 

The operator places himself close to the animal's back. The in- 
cision may be made in one of three different places. 

Certain practitioners recommend a vertical incision about 2 to 




Fig-. 322. — Genital organs of the sow. 1, Ovary ; 2, horn of the uterus 
3, uterus ; 4, rectum ; 5, vagina ; 6, bladder ; 7, kidney ; 9, intestine. 



21 inches in length, commencing at the external angle of the ilium, 
or ^ of an inch in front of it, and prolonged downwards ; others 
make a horizontal incision parallel with the vertebral axis ; and, 
lastly, some believe that an oblique incision following the direction 
of the "cord of the flank" is just as advantageous. A vertical or 
oblique incision is probably the best. 

The operation comj^rises four stages : 

First stage. Incision of the skin and subjacent muscles. 

Second stage. Perforation of the peritoneum and discovery of the 



ovaries. 



CASTRATION. 



767 



Third stage. Ablation of the ovaries or of the ovaries and horns 
of the uterus. 

Fourth stage. Suture of the wound. 

The tissues are divided layer by layer. The skin is formed into 
a longitudinal fold and divided in a vertical direction, and the sub- 
jacent muscular layers are then divided with the bistoury. The 
tissues are next broken through layer by layer with the index finger 
until the parietal peritoneum is reached. This membrane is then 
fissured, or at least scraped with the nail, and perforated with a 
sudden sharp thrust of the index finger. 

This practice, however, has the disadvantage of sometimes causing 
the parietal peritoneum to strip away from the wall of the abdomen 
which greatly increases the difficulties of opera- 
tion. It is better, therefore, to grasp the peri- 
toneum wath a small pair of forceps, draw it out- 
wards, and secure it so. as to puncture it with 
more certainty. When experience has been ac- 
quired this precaution will be unnecessary. 

The incision being made and the finger in- 
troduced into the abdomen, the operator, who 
kneels against the animal's back, searches for 
the ovaries with his index finger. The upper 
ovary of the side in which the incision has been 
made will be found immediately in contact with 
the parietal peritoneum, and the operator must 
take care not to displace it by untimely or care- 
less manipulation, which may thrust it away 
among the loops of intestine. The finger being 
doubled up in the form of a hook, the ovary is 
seized and draw-n out. Sometimes it may be 
easier to withdraw the uterine horn, leaving the search for the ovary 
until a little later. 

The first ovary having been discovered, its pedicle is seized 
between the left thumb and index finger or the jaws of pressure 
forceps, and then the search is continued for that of the opposite 
side. In young sows the horn of the uterus may be followed up 
from its extremity (ovarian extremity) towards its origin (bifurcation 
of the body of the uterus) and the search continued along the horn 
of the uterus of the opposite side, which is followed in the reverse 
direction from its base towards its extremity until the second ovary 
is found. 

The most difficult stage is that at which the change is made from 
one horn to the other, for this is the moment when the contraction 




Fig. 323— Castrating 
knives. 



768 GENITO-URINARY ORGANS. 

of the parts is most violent, the animal's struggles most energetic 
and the pain most acute, so that great care must be taken not to 
let go the horn which has already been secured. 

When the second ovary appears at the external orifice, it is secured 
like the preceding, and both are removed by torsion. The horns of 
the uterus are then freed and returned to the abdominal cavity, the 
wound is thoroughly disinfected and united with from one to three 
interrupted sutures passed through the skin. The animal is then 
allowed to rise. Complications are rare. 

In small females the uterine horns are often removed by tor- 
sion along with the ovaries. In adults, only the ovaries are 
removed. 

Subsequent Precautions: Operative Accidents. — The patients are 
kept on low diet for some days after operation. Accidental stripping 
away of the peritoneum at the seat of operation may sometimes 
result in the formation of a little abscess when the wound has been 
infected. This is diagnosed by direct examination or palpation. The 
lips of the wound are then opened in order to permit the pus to 
escape and avoid peritonitis. Should the horns of the uterus or the 
broad ligaments be roughly manipulated, they may be torn to some 
extent, but this rarely causes grave complications. 

Bleeding from the incision in the abdominal wall is of little 
importance. 

Hernia rarely occurs, for the opening in the peritoneum is of 
very small size. 

In rare cases, and when care is not used, a portion of the intestine 
may be sutured to the margin of the wound. The intestine then 
becomes adherent to the abdominal wall, but grave results seldom 
follow. 

SUTURE OF THE VULVA 

In cases of recurrence after reduction of an inversion of the 
uterus or the vagina it may become necessary to suture the vulva 
in order to control the effects of straining. 

Several forms of suture are employed ; the best are probably 
those of Eainard and Strebel. 

Simple Suture. — Simple suture may be formed of very flexible 
copper wires. Three are usually inserted, one at the base, one about 
the middle, and one near the upper third of the vulval opening. 
The ends of each suture are knotted and drawn moderately tight over 
the opening, then one of the ends of the highest knot is united verti- 
cally to an end of the middle knot, and the latter in its turn is simi- 
larly secured to the lowest knot. 



SUTUllE OF THE VULVA. 



7G9 



To be reliable, sutures should embrace the entire thickness of the 
lips of the vulva. 

Rainard's Suture. — Eainard's suture consists only of two oblique 
stitches, crossed in the form of the letter "X," starting from the upper 
third of one of the lips of the vulva and terminating in the lower 
third of the opposite lip. The ends are tied opposite the centre of 
the vulval opening. 

Strebel's Suture. — Strebel's suture consists of three stitches inserted 
transversely. The material employed is galvanised wire, sharpened 
at one end and rolled into a flat spiral at the other. Each wire, 




Fig. 324. 

which plays the part of a needle, is inserted separately, and is after- 
wards twisted into a spiral by means of special forceps, the excess of 
length being thus taken up until the lips of the vulva are brought 
closely in contact. 

In practice, in order to avoid the cutting and irritant effect of 
such sutures and to increase their efficiency, two rectangular pieces 
of leather are applied on either side through holes in which the 
actual metallic sutures are passed. West's vulval clamp is better 
than sutures. It is very popular in England 

TRUSSES. 

Trusses applied for the purpose of preventing prolapsus of the 
genital organs are now almost entirely given up, as they very im- 
perfectly achieve their object. 



D.c. 



3D 



770 



GENITO-URINARY ORGANS. 



Lund's truss, shown in the ihustration (Fig. 325), is perhaps the 
most efficient of those which survive. The essential portion of this 
is of metal, and is approximately of the shape of the letter " V." 
The two ends may be separated and drawn together at will by means 
of a cord. This apparatus is held in contact with the vulva by 




i^'iG. 325. — Lund's truss. 

means of strings which pass through eyes in the metallic triangle 
and are secured to a collar placed on the neck or to a girth secured 
round the chest. 

SECTION OF THE SPHINCTER OF THE TEAT. 

This operation is performed to render easily pervious the ends of 
teats which have undergone contraction as a consequence of changes 
in the sphincter or from some other cause. 

The animals are secured, and the teat to be operated on having 
been grasped between the index finger and thumb of the left hand, 
the point of the little cutting instrument shown in Fig. 326 is intro- 
duced into the opening of the teat, and it is then thrust in as far 
as the shoulder on the cutting edges. 



DILATATION OF THE ORIFICE OF THE TEAT. 

The results of the above operation not always proving permanent, 
and cicatricial contraction often following after a few weeks' time, 



ABLATION OF THE MAMMJi. 



771 



forced dilatation by means of the conical tubes shown (Fig. 327) has 
been generaUy substituted for it. Three instruments of vaijing thick- 
ness are usually sufficient. Forced dilatation may be effected at a 
smgle operation, and has not the drawback of causing cicatrices. 




Fig. 326. 




Fig. 327. 



ABLATION OF THE MAMM^, 

Ablation of the mammae is rather frequently necessary, principally 
m cases of gangrenous mammitis, of prolonged, continuous suppura- 
tion, or of grave mammitis, where death would otherwise follow. 

Provided the anatomical structure of the parts is known (Fig. 287) 
ablation does not present any insuperable difficulty. 

In the cow, either two lateral quarters or the entire udder must 
be removed. The lines of incision through the skin should first of 
all be traced. 

One half of the udder may be removed by the following method • 

First stage. Elliptical incision through the skin, including the 
two teats of one side. 

The lines of incision should extend backwards sufficiently hioh to 
enable the vessels at the base of the gland to be easily lioatured 

Second stage. Dissection and breaking down- of the subcutaneous 
and mtermammary connective tissue. The anterior mammary vein 
must be ligatured. 

Third stage. Isolation of the mamma from the front backwards 
and ligature of the vessels of supply. Extirpation. 

3 D 2 



772 



GENITO-URINAUY OEGANS, 



Fourth stage. Suture and drainage of the operative wound with 
iodoform gauze. 

This operation appears to cause formidable injuries, the abdominal 





.v^^^ 







Fig, 328 —Ablation of the udder in the cow. L-i, Line of incision ; 
L^j, prolongation backwards. 



/^^^^^P^^ 




Fig. 329.- -Ablation of the udder in the goat. L^, Line of 
incision; Lp, prolongation backwards. 

tunic and the muscles of the flat portion of the thigh being largely ex- 
posed, but in reaUty the wound is less grave than might be supposed, 



ABLATION OF THE MAMM^. 773 

and healing occurs in a comparatively short time, provided none of 
the diseased tissue is left. 

The dressing is renewed at intervals of two or three days, and 
when cicatrisation proceeds regularly it may be omitted and re- 
placed by antiseptic irrigation. 

In the ewe and she-goat the operative technique is identical : 

First stage. Elliptical incision, including the teat. 

Second stage. Breaking through of the intermammary connective 
tissue partition and the subcutaneous tissue. Ligature of the anterior 
mammary vein. 

Third stage. Isolation of the mamma from the front backwards. 
Ligature of the vessels of supply. Extirpation. 

Fourth stage. Suture and drainage. 



INDEX 



A. 



Abdominal cavity, diseases of 
Ablation of the niammje 
Abomasal indigestion 
Abomasum .... 
„ hernia of the 

,, obstruction ol tlie 

,, strongylosis of, in the ox 

Abortion, epizootic, in cows . 
Acariasis, non-psoroptic forms of 
Accessory glands of the genital apparatus 
Accidental phlebitis 
Acid theory in diseases of bones 
Acids, caustic, poisoning by 
Acne in the sheep . 
Acoi-ns, poisoning by 
Acquired herni^e . 
Actinomycosis 

Actual cautery, castration with th 
Acute cystitis 

,, deep-seated glossitis 

,, eczema 

,, enteritis 

,, gastric indigestion in 

,, gastritis 

,, inflammation of the gastric com- 
partments 

,, laryngitis 

,, mammitis . 

.. metritis 
nephritis 

„ parotiditis . 

,; peritonitis . 

,, pleurisy 

,, tuberculosis. 

,, vaginitis 
^sculacese 
Agalaxia 
Agaricace« . 

Alkalies, caustic, poisoning by 
Aloes, poisoning by 
Alsinaceffi 
Ambrosiaceje . 
Amputation of the claw 
Anemia in cattle . 
„ lambs . 

,, sheep . 

Anesthesia . 

Annual mercury, poisoning by 
Anomalies, physiological 
Anus .... 

,, imperforate . 



PAGE 

478 
771 
182 
Hi 
493 
194 
2(i8 
553 
645 
597 
39(1 
3 
217 
606 
228 
489 
672 
758 
511 
131 
599 
203 
1S5 
188 

186 
333 
573 
550 
528 
134 
478 
361 
704 
544 
246 
587 
225 
217 
221 
229 
256 
730 
268 
268 
268 
726 
256 
567 
116 
742 



Apiacee 

ApocynacefB 

Apparatus of locomotion 

AriuiaUu.<i splcatns^ poisoning hy . 

Arsenic, poisoning by . 

Arsenical dips .... 

Arteries, examination of 

" Arthritis of milch cows " . 

Articular rheumatism . 

„ ,, causes 

,, .. complications 

Articulations, diseases of 

Ascites 

Asclepiadaceas .... 

Aspergilli, pneumo-mycosis due to 



B. 



PAGE 

247 

251 

730 

237 

218 

632 

371 

99 

89 

89 

91 

45 

483 

252 

350 



Barberry family . 

Beech family .... 

Beef measles . . . .■ 

,, ,, symptoms 

,, ,, where prevalent 

Bell-flower family . 
Berberidacee 
Biceps femoris 
Bile ducts, cancer of 
Bilharziosis in cattle and sheep 
Bistournage .... 
Bitter milk .... 
Bladder, diseases of the . 
„ eversion of the 
,, paralysis of the 
Bleeding .... 
„ in the pig 
„ in sheep . 
Blood, diseases of the . 
examination of . 
,, poisoning in sheep and lambs in 

New Zealand . 
., -vessels, diseases of 
Blood- wort family . 
Bloody flux in calves and lambs 
Blue milk .... 
Boars, castration of 
Bog spavin in the ox 
Bone, actinomycosis of . 

,, tumours .... 
Bones and articulations, tuberculosis of 
the 



235 

228 

79 

79 

81 

79 

255 

235 

70 

282 

439 

751 

591 

511 

519 

519 

727 

728 

727 

406 

372 

415 
396 
228 
271 
590 
759 

46 
681 

30 

701 



776 



INDEX. 





PAGE 1 


PAG^ 


Bones, diseases of 


3 


Castration by the exposed method 


757 


„ „ acid theory 


8 


„ „ torsion .... 


757 


„ „ inflammation theory . 


4 


„ of boars and young pigs 


759 


„ „ theory of insufficiency 


3 


„ ,, the bull and ram 


751 


Bovine animals, calculi in . 


515 


„ ,, cow .... 


761 


,, piroplasmosis 




416 


„ ,, cryptorchids 


760 


Box family . 




246 


„ „ the ram . . . . 


759 


Brain, tuberculosis of the 




702 


„ „ „ ,, by bistournage . 


759 


Braxy .... 




435 


„ „ „ „ ligature . 


759 


Bronchi . 




333 


„ „ „ „ „ tearing . 


759 


Bronchitis 




336 


„ „ sow .... 


765 


,, chronic . 




337 


„ with the actual cautery 


758 


■„ pseudo-membranous 


339 


Catarrhal gastritis in swine . 


190 


„ simple acute . . . . 


337 


„ stomatitis in sheep 


122 


„ verminous, in sheep and 




„ „ general, in swine . 


126 


cattle .... 


340 


Catheter, passage of the, in the cow 


750 


Broncho-pneumonia, gangrenous, due to 




„ „ „ ,, ram 


749 


foreign bodies . 


351 


Cattle, ansemia in 


268 


,, „ infectious 


354 


,, bilharziosis in . 


439 


„ „ of sucking calves . 


356 


,, diarrhoea in ... . 


268 


„ „ sclero-caseous, of 




„ hemorrhagic septicemia in 


716 


sheep 


358 


„ parasitic gastro-enteritis in 


268 


Bryony, poisoning by . 


256 


,, pseudo-membranous pharyngitis 




Buckwheat poisoning .... 


606 


in 


141 


Bull, castration of the .... 


751 


,, verminous bronchitis in . 


340 


Bunch-flower family .... 


227 


Caustic acids, poisoning by . 


217 


Bursal sheath of the flexor tendcns, dis- 




,, alkalies, poisoning by 


216 


tension of . 


49 


Cerebral congestion .... 


456 


Butneriaceae 


235 


,, tumours 


459 


Butter, milk without .... 


589 


Changes in the milk .... 


587 


Buxacese . . . 


246 


Chaps 


568 






Chemical dyspepsia .... 


195 






Chenopodiacee 


229 


C. 




Chorioptic mange . . . 636, 64C 


,642 






Chronic bronchitis .... 


337 


Calculi in bovine animals . • . 


515 


„ cystitis ....". 


513 


,, urinary, in sheep . 


518 


„ diarrhoea 


207 


Calculus formation .... 


514 


„ eczema 


600 


Calves, depraved appetite in . 


160 


„ enteritis 


207 


,, diarrhoeic enteritis in 


212 


„ gastritis 


194 


„ dysentery in ... . 


210 


„ glossitis 


132 


„ goitre in 


453 


„ indigestion .... 


194 


,, intestinal coccidiosis of . 


271 


,, mammitis. .... 


581 


„ lumbricosis of . 


267 


,, metritis 


552 


,, mycotic stomatitis in 


124 


,, nephritis 


530 


,, necrosing stomatitis in 


123 


„ parotiditis .... 


136 


Calving, dropping after . . , . 


461 


,, pericarditis . . 


389 


Campanulaceae 


255 


„ peritonitis . . 


481 


Cancer of the bile ducts 


282 


„ pleurisy 


362 


„ liver . . . . 


282 


„ simple synovitis, forms of 


45 


Cancerous pericarditis . . . . 


375 


„ tympanites .... 


194 


Canker 


40 


„ vaginitis ..... 


546 


„ treatment 


41 


Circulation, organs of the 


370 


Capillary system, examination of . 


372 


Circulatory apparatus .... 


727 


Carbolic acid poisoning . . . . 


221 


Clams, castration by ... . 


756 


clips 


633 


Claw and third phalanx, disarticulation 




Cardiac anomalies 


374 


of the 


731 


Carduacege 


256 


„ amputation of the 


730 


Carrot family 


247 


„ surgical dressing for a . 


730 


Caseous lymphadenitis of the sheep 


453 


Claws, congestion of the 


31 


Casting, control of oxen by . 


723 


Clement's bath 


623 


Castor-oil cake, poisoning by 


257 


Clotted milk 


589 


Castration 


751 


Coenurosis 


467 


„ complications after 


760 


Colchicum poisoning .... 


256 


„ by clams . . . . 


756 


Cold water, colic due to ingestion of . 


162 


„ „ the covered method 


757 


Colic 


116 


„ ,, „ elastic ligi 


iture . 


758 


,, as a result of strangulation . 


167 



INIDEX. 



777 





tAGE 




PAGE 


Colic due to invagination 


163 


Digestive apparatus 


. 734 


„ in the ox . . 


162 


,, ,, diseases of . 


. 106 


Common salt, poisoning by . 


217 


,, „ fistulfB of 


. 500 


Complications after castration 


760 


„ „ parasites of . 


. 2H3 


Condylomata ...... 


38 


,, ,, semiology of . 


. 106 


Congenital hernife 


487 


Digestive tract, tuberculosis of the 


. 699 


Congestion, pulmonary . . . . 


343 


Dilatation of the oesophagus . 


. 149 


,, of the claws 


31 


„ ,, orifice of the teat 


. 770 


„ „ kidneys . 


527 


Disarticulation of the claw and thii 


d 


„ liver 


280 


phalanx 


. 731 


„ „ udder 


570 


„ „ two first phj 


i- 


Congestive colic .... 


162 


langes . 


. 732 


Conjunctivitis .... 


662 


Diseases of the bladder . 


. 511 


Contagious disease (takosis) of goats . 


412 


„ ,, blood 


. 406 


„ mammitis in milch cows 


580 


„ „ kidneys . 


. 527 


,, vaginitis . . . " 


545 


„ „ liver 


. 279 


" Contagious foot disease " 


41 


„ ,, lymphatic system . 


. 444 


Contraction of the sphincter 


567 


,, „ mouth . 


. 106 


Control of pigs 


725 


„ „ oesophagus 


. 109 


„ sheep and goats . 


725 


„ „ pharynx 


. 108 


„ oxen .... 


720 


„ „ salivary glands 


. 108 


„ „ by casting . 


723 


„ „ stomach . . 1 


10, 169 


,, general, of oxen 


722 


„ ,, rumen . 


. 110 


Contusions of the sole . 


31 


„ „ peritoneum and abd 


3- 


Convallariacese .... 


228 


minal cavity 


. 478 


Copper poisoning .... 


221 


,, „ urinary apparatus . 


. 502 


Coryza, gangrenous . . . 


320 


„ produced by distillery and sug 


w 


„ simple .... 


319 


factory pulp 


. 259 


Cotton cake, poisoning by 


257 


„ transmissible to man throua 


^h 


Covered method, castration by the 


757 


the medium of milk 


. 593 


Cow, castration of the . 


761 


Distillery and sugar factory pul 


P' 


., „ „ complications in 


764 


diseases produced by . 


. 259 


„ passage of the catheter in the 


750 


Distomatosis 


. 293 


Cows, epizootic abortion in . 


553 


Disturbance in the milk secretion . 


. 587 


Cowper's glands .... 


597 


Dogbane family .... 


. 251 


Cow-pox 


665 


Dropping after calving . 


. 461 


„ and human variola . 


669 


Dysentery in calves 


. 210 


Cracks 


568 


., ,, and lambs 


. 271 


Creolin bath 


824 


Dyspepsia . . 


. 194 


Croupal vaginitis .... 


545 


,, motor .... 


. 195 


Crowfoot family .... 


230 


„ secretory or chemical . 


. 195 


Crushing a foreign body in the oesophagus 


735 






Cryptorchids, castration of . 


760 






Cysticerci, infection with 


73 


E. 




Cysticercosis 


290 






„ peritoneal . 


485 


Echinococcosis of the liver 


. 283 


Cysticercus disease of the pig 


73 


,, suppurative . 


. 288 


Cystic parasites of animals, table of 


73 


Ectopia of the heart 


. 374 


Cystitis, acute .... 


. 511 


Eczema 


. 599 


,, chronic .... 


. 513 


„ acute .... 


. 599 


Cysts of the udder .... 


. 585 


„ chronic . . . , 
„ due to feeding wath pota 


. 600 
to 






pulp .... 


. 603 


D. 




„ sebaceous or seborrhoeic . 


. 601 






Elastic ligature, castration by the 


. 758 


Defecation : examination of freca 


I 


Emphysema, pulmonary 


. 359 


material 


. 118 


„ subcutaneous . 


. 659 


Demodecic mange .... 


. 643 


Encephalitis 


. 458 


Depraved appetite .... 


. 158 


Endocarditis 


. 394 


„ „ in calves and lambs 


. 160 


Enteritis 


. 203 


V ,, ,, the ox . 


. 158 


„ acute . . . 


. 203 


Diaphragmatic hernias . 


. 496 


„ chronic .... 


. 207 


Diarrhoea, chronic .... 


. 207 


,, diarrhoeic, in calves 


. 212 


,, in cattle 


. 268 


„ - hgemorrhagic . 


. 206 


„ ,, lambs 


. 268 


Epizootic abortion in cows . 


. 553 


„ ,, sheep 


. 268 


Equisetaceaj 


. 225 


Diarrhoeic enteritis in calves . 


. 212 


Ergot family 


. 223 



778 



INDEX. 



PAGE 
223 
223 
249 
2U 
499 
519 
27 
757 



Ergot of rye, poisoning by 

Ergotism 

Ericaese .... 

Euphorbiacere 

Eventration . 

E version of the bladder 

Exostoses 

Exposed method, castration by the 

External ischio-tibial muscle, rupture 

of the 70 

Exudative pericarditis due to foreign 

bodies 376 

Eyes, diseases of the .... 661 



F. 



Facial sinuses of sheep, oestrus larvae 
in the 
„ „ trephining the 

Fgecal material, examination of 
Fagace^ 
Fagopyrism . 
False sturdy . 
Fasoiola hejjatica 
Felon 
Female genital organs, examination of 

with the speculum 
Femoro-tibial articulation, luxation of 
the. 
,, ,, symptoms 

,, ,, treatment 

Femur, luxation of . . . 

,, „ „ symptoms 

„ „ ,, treatment 

Fennel, poisoning by . . 
Ferments, lactic .... 
Fern family . . . ' . 
Fetlock joint, distension of the synovial 
capsule of the 
„ strain of . 
Figwort family .... 
Fistula, parotid .... 

Fistulse, milk 

,, of the digestive apparatus 

Flax family 

Flexor metatarsi, rupture of the . 
,, tendons, distension of the bursal 
sheath of 
Food, poisoning due to 
Foot, diseases of the 
,, rot 

,, ,, symptoms . 
,, ,, treatment 
„ scab 

Foreign bodies causing diseases of the 

eyes 

„ ,, exudative pericarditis 

due to 
,, „ gangrenous broncho 

pneumonia due to 
,, ,, gastric disturbance due 

to 

„ ,, migration of, from the 

reticulum, pneumonia 
due to . . . 



330 
745 
118 
228 
606 
330 
294 
41 

760 

61 
62 

63 

56 

57 

58 

249 

588 

225 

48 
54 

255 
136 
569 

500 
244 

72 

49 
215 
31 
43 
43 
44 
636 

661 

376 

351 

198 



348 



PAGE 

Foreign bodies, pneumonia due to . 347 
Foreign body in the oesophagus, crush- 
ing a . 735 
,, „ ,, ,, sub-mucous 
dissection 
of . . 736 

Fractures 20 

France, bovine piroplasmosis in . . 424 

Frontal sinus, trephining the . . 745 

„ „ purulent collections in . 327 



G. 



G-ANGRENOUS broncho-pneumonia due 




to foreign bodies 


351 


„ coryza .... 


320 


,, mammitis in goats 


584 


„ „ of milch ewes . 


583 


Gaseous indigestion .... 


170 


Gastric compartments, acute inflamma- 




tion of . 


186 


„ „ tumours of the . 


202 


,, disturbance due to foreign bodies 


198 


,j indigestion, acute, in swine 


185 


Gastritis . . . .186, 188- 


-194 


Gastro-intestinal strongylosis in sheep . 


263 


Gastrotomy .... 




739 


" Gathered Nail " . 




37 


General diseases 




4 


Genital apparatus . 




542 


„ ,, accessory glan( 


Is of 




the 




597 


„ malformations . 




560 


., organs, male 




594 


„ „ tuberculosis of the 




700 


Genito-urinary organs . 




747 


„ regions . 




502 


Gid 




467 


Glands, mammary, diseases of 




565 


Glans penis and sheath, polypi of 




506 


Glossitis .... 




130 


,, acute, deep-seated . 




131 


„ chronic 




132 


„ nodular sclerosing . 




133 


„ superficial 




130 


Goat, demodecic mange in the 




644 


,, mange in the 




641 


,, ringworm in the . 




653 


Goats, control of . 




725 


„ gangrenous mammitis in 




584 


Goitre in calves 




453 


,, lambs 




453 


Goosefoot family . 




229 


Grass family .... 




226 


„ tick, life history of 




432 


Grease 




41 



H. 



HEMATURIA .... 

Hsemodorace^ . . . . 
Hsemorrhagic enteritis . 

,, „ in calves 

lambs . 

.. septicemia in cattle 



and 



520 
228 
206 

271 

716 



INDEX. 



779 



Hemorrhagic septicaemia, infective dis- 



eases confused with . 


. 718 


Haunch, hygroma of . . . 


67 


Heart, ectopia of the ... 


. 374 


Heat stroke ..... 


. 442 


Heath family .... 


. 249 


Hellebore, poisoning by 


. 234 


Helminthiasis, intestinal, in ruminants 


, 275 


Hemlock, poisoning by . 


. 248 


Hepatitis, nodular necrosing . 


280 


Hernia, inguinal, in young pigs . 


741 


,, of the abomasum 


493 


,, ,, intestine 


494 


,, „ rumen 


490 


,, perineal, of young pigs . 


487 


Herniffi 48 


7,741 


„ acquired .... 


489 


„ congenital 


487 


,, diaphragmatic . 


496 


„ treatment of . . . 


495 


Hock, hygroma of the point of the 


68 


,, joint, distension of the synovia 




capsule of the 


46 


„ ^ „ strain of . 


55 


,, region, distension of the tendon 




sheaths in . . . 


46 


Hoose 


340 


Horn core, trephining the 


745 


Horns, anatomy of . . . 


21 


„ detachment of . 


23 


,, Assuring of . . ., . 


24 


„ fractures of . . . 


21,25 


,, splints for 


26 


,, treatment of ... . 


25 


Horse-chestnut family . . . . 


246 


Horsetail family . . . . . 


225 


Human variola and cow-pox 


669 


Husk 


340 


Hydro-nepbrosis 


531 


Hydro-pneumo-thorax . . . . 


366 


Hygroma of the haunch 


67 


„ „ knee . . . . 


65 


„ „ point of the hock 


68 


„ ,, point of the sternum . 


69 


„ „ stifle . . . . 


67 


„ „ trochanter of the femur 


67 


Hygromas 


64 


Hypericaceae 


246 


Hypocreceas 


223 


Hypodermosis in the ox. . . . 


646 



Infectious diseases . ^ . . 

,, pyelo-nephritis 

,, pseudo-rheumatism in adults 

,, ,, ,, symptoms 

,, ,, „ treatment 

,, rheumatism in young animals 

,, „ ,, causes 

,, ,, „ symptoms 

Infective diseases, confused with hemor- 
rhagic septicemia 

Inflammation of the sheath . 

,, ,, sub-maxillary sali 

vary gland. 

Inflammatory diseases . 

Inguinal hernia in young pigs 

Insolation 

Interdigital space, inflammation of the 

Internal infectious phlebitis . 

Interstitial mammitis . 

Intestinal helminthiasis in ruminants 
„ tuberculosis . 

Intestine 

,, hernia of the . 

Invagination, colic due to 

Inversion and prolapsus of the rectum 

Iodine poisoning .... 

lodism 

Iodoform poisoning 

Ischial urethrotomy 

Ischio-tibial muscle 
of the 

Issues 



external, rupture 



Joints, luxation of 



J. 



K. 



PAGE 

665 

533 

99 

100 

103 

94 

94 

95 

718 
506 

137 
570 
741 
460 
38 
398 
574 
275 
699 
116 
494 
163 
743 
222 
222 
222 
747 

70 

728 



56 



Keratitis . 




662 


Kidney worm of swine . 


. 


539 


Kidneys, congestion of the 
,, diseases of the 




527 
527 


Knee, distension of tendon 


sheaths in 




the region of . 

„ hygroma of 

„ joint, distension of the synovial 

capsule of the .... 
„ strain of 


49 
65 

47 
53 









Lactic ferments .... 


588 


Impaction of the omasum . 


179 


Lambs 


, anemia in . . . 


268 


^^ 


„ rumen 


175 


^^ 


blood poisoning in, in New Zea 




Imperfor 


ate anus .... 


742 




land .... 


415 


') 


condition of the teat . 


567 


,, 


depraved appetite in 


160 




vagina 


560 


^j 


diarrhoea in . . . 


268 


Impetigo 


in the pig 


605 


„ 


goitre in . 


453 


Indigestion . . 


170 


J, 


intestinal coccidiosis of 


271 


5) 


abomasal 


182 




parasitic gastro-enteritis in 


268 


I) 


acute gastric, in swine 


185 


Laminitis 


32 


)1 


as a result of over-eating 


175 


)) 


symptoms 


33 


}? 


chronic 


194 


55 


treatment 


34 


Infectious broncho-pneumonia 


354 


Laparotomy 


740 



780 



INDEX. 





PAGE 








PAa E 


Larkspur poisoning in sheep . 


. 231 


Mammitis, gaiigrenOus in goats 




584 


Laryngitis 


. 333 


„ „ of milch ewes 


583 


„ acute .... 


. 333 


,, interstitial . 


, 


574 


„ pseudo-membranous 


. 333 


,, parenchymatous 




. 


575 


Larynx ..".... 


. 333 


Mange .... 






611 


,, examination of 


. 313 


„ chorioptic . 




636, 640 


,642 


,, tumours of . . . 


. 335 


,, demodecic . 








643 


Lathyrism 


. 243 


„ in the goat 






. 


641 


Lead poisoning .... 


. 220 


„ ox . 








638 


Licking habit .... 


. 158 


J5 „ pig • 








642 


Lily of the valley tamilj 


. 228 


„ psoroptic . 






.' 614 


, 639 


Lime and sulphur dips . 


. 627 


„ sarcoptic . 






. 638 


, 641 


„ „ prejudiceagains 


b 628 


„ symbiotic . 








636 


Linacese . . . ... 


. 2U 


Manual technique in bistournage 




752 


Liver 


. 119 


,, „ castration of the cow 


762 


„ cancer of ... . 


. 282 


" 5) :> jj 


sow 


766 


„ congestion of ... 


. 280 


Martelage .... 




756 


,, diseases of . 


. 279 


Maxilla, actinomycosis of the 




673 


,, echinococcosis of . . . 


. 283 


Maxillary sinus, purulent collections in 


329 


„ rot 


. 293 


„ „ trephining the 


. 


745 


Liver-fluke (Fasclola hepatica) . . 


. 294 


Measles, beef .... 




79 


„ disease 


. 293 


pork. 




78 


Local affections .... 


. 20 


Mechanical pneumonia . . ' 




347 


Locomotion, apparatus of 


730 


Mediastinum, diseases of structures 




„ organs of, diseases of 


1 


enclosed within 


the . 


368 


„ gait in 


1 


„ tuberculosis of the 




697 


,, inspection for . 


1 


,, tumours of . 




369 


„ palpation and pressure tc 




Medicated milk 




591 


detect . 


1 


Melanthacese .... 




227 


„ percussion in 


1 


Meliaceai .... 




244 


Louping ill 


429 


Meningitis .... 




456 


Lumbar prurigo, or " trembling," ir 




Mercurial poisoning 




219 


sheep 


475 


„ stomatitis 




128 


Lumbricosis of calves . 


267 


„ „ nature of 




129 


Lund's truss 


770 


Metritis 




547 


Lungs . 


343 


„ acute 




550 


Lupines, poisoning by . 


241 


„ chronic 




552 


Luxation of the femoro-tibial articula 




„ septic 




547 


tion . 


61 


Microbic changes in milk 




588 


„ „ femur . 


56 


Migration of foreign bodies fror 


Q the 




patella 


58 


reticulum, pneumonia due to 




348 


„ „ scapulo-humeral joint 


63 


Milch cows, contagious mammitis 


in . 


580 


Lymphadenitis .... 


448 


„ ewes, gangrenous mamm_itig 


of . 


583 


Lymphatic glands, tuberculosis of 


696 


Milk, bitter .... 




591 


,, glandular apparatus, topo- 




„ blue .... 




590 


graphy of . 


445 


„ changes in the 




587 


„ system, diseases of 


444 


„ clotted .... 




589 


Lympho-cythsemia 


448 


„ diseases transmissible ' to 


man 




Lymphogenic diathesis . 


448 


through the medium of 
„ fever .... 
„ fistulse .... 
,, medicated 




593 
461 
569 
591 


M. 




,, microbic changes in 

„ mucous, viscous, or thready 




588 
589 


Magnoliace^ .... 


229 


„ preservation of 




591 


Magnolia family .... 


229 


,, putrid .... 




589 


Maize, poisoning by the male tufts of 


226 


„ red .... 




590 


Male genital organs . . . . 


594 


„ secretion, disturbance in the 




587 


Malformations, genital . 


560 


„ thready 




589 


Malignant oedema 


415 


,, viscous .... 




589 


Mamm:©, ablation of the 


771 


„ without butter 




589 


Mammary glands, diseases of 


665 


,, yellow .... 




590 


„ toxgemia . . . 


461 


Milkweed family .... 




252 


Mammitis 


571 


Molasses refuse, poisoning by 




258 


„ acute 


573 


Motor dyspepsia .... 




195 


„ chronic . . . . 


581 


Mouth, diseases of . 


106, 


121 


,, contagious, in milch cows . 


580 


Mucous milk . 








589 



INDEX. 



781 



PAGE 

Muguqt 124 

Muscles and tendons, diseases of . .70 

,, parasitic diseases of . . .73 

Muscular rheumatism .... 92 

Mushroom family 225 

Mycotic stomatitis in calves . . .124: 
Myelo-cythtemia 448 



N. 



Nails, picked-up 37 

Nasal cavities 319 

,, ,, examination of . .311 

,, ,, tumours of . . . 325 

„ gleet . . . . . .326 

„ sinuses, purulent collections in . 326 
Neck, actinomycosis of the . . . 675 
Necrosing stomatitis in calves . .123 

Nephritis, acute 528 

,, chronic 530 

,, suppurative .... 537 

Nervous system ..... 456 

Nettle family 229 

New-born animals, septicemia of . . 406 
,, „ umbilical phlebitis of 399 

New Zealand, blood poisoning in sheep 

and lambs in 415 

Nitrates of potash and soda,'poisoning by 21 7 
Nodular necrosing hepatitis . . . 280 
,, sclerosing glossitis . . .133 
Non-psoroptic forms of acariasis . . 645 
Nympho-mania . .... . 562 



0. 



Obstruction of the abomasum . . 194 

(Esophageal obstructions . . .152 

„ „ treatment . 154 

„ sounds . . . .155 

CEsophagitis 145 

(Esophagotomy . . . .156, 736 

GEsophagus 734 

,, dilatation of . . . 149 

,, diseases of . . .109, 145 

,, ruptures and perforations of 157 

,, stricture of . . . .148 

(Estrus larve in the facial sinuses of 

sheep 330 

Oleacege 251 

Olive family 251 

Omasum 113 

,, impaction of the . . .179 

Omphalo-phleVjitis 402 

" Open arthritis " 51 

'' Open synovitis " . . . . .49 

Operations 720 

Ophthalmia, verminous, of the ox . . 663 

Organs of circulation, semiology of . 370 

,, locomotion, diseases of . . 1 

,, „ „ methods 

of examination in .... 1 

Orifice of the teat, dilatation of the . 770 

Osseous cachexia 7 

„ ,, causes of . . .14 

„ „ histoiy of . . . 8 



PAGE 
Osseous cachexia, phases of . . 9 — 11 

,, ,, symptoms of . .8, 11 

,, ., treatment of . . 18 

Ostitis, suppurating .... 29 
Ovary, tumours of the . * . . . 559 
Over-eating, indigestion as a result of . 175 

Over-exertion 442 

Ovine pasteurellosis .... 263 
,, piroplasmosis .... 425 

Ox, colic in the 162 

demodecic mange in the . . 644 

depraved appetite in the . . 158 

hypodermosis in the . . . 646 

mange in the 638 

strongylosis of the abomasum in the 268 
urethrotomy in the . , . 747 

verminous ophthalmia of the . . 663 

Oxen, canker in 40 

„ control of 720 

,, ,, by casting . . . 723 
„ „ the limbs . . .720 
„ warts in 655 



Panaritium 41 

Pancreas . . . ' . . . 119 

Papaveracege 235 

Papillomata, verrucous, of the udder . 586 

Paralysis of the bladder . . .519 

Parasites, cystic, of animals, table of . 73 

,, of the digestive apparatus . 263 

Parasitic diseases of muscles ... 73 

„ gastro-enteritis . . . 268 

„ „ in cattle . 268 

,, ,, in lambs . 268 

,, „ in sheep . 268 

Parenchymatous mammitis . . . 575 

Parotid fistula 136 

,, glands, actinomycosis of the . 675 

Parotiditis (Parotitis) . . . 134, 136 

Parturient apoplexy .... 461 

Passage of the catheter in the cow . 750 

„ ,, ,, ram . 749 

Passing the probang .... 735 

Patella, luxation of . . . .58 

„ ,, bandage for . . 60 

,, ,, symptoms . . 59 

,, ,, treatment . . 60 

Patellar synovial capsule, inflammation of 45 

Pea family 236 

Pelvis, fractures of .... 20 

Pericarditis 375 

,, cancerous . . . .375 

,, chronic .... 389 
„ exudative, due to foreign 

bodies .... 376 

„ simple acute . . . 375 

„ specific .... 375 

Perineal hernia of young pigs . . 487 

Perinephritis 537 

Peripneumonia and pneumonia, difi'er- 

ences between 347 

Perisporacete 223 

Peritoneal cysticercosis . . . 485 

Peritoneum, diseases of ... 478 



782 



INDEX. 







PAGE 


PAGE 


Peritonitis 




478 


Poisoning by bryony . . . . 


256 


„ acute . 




478 


,. „ castor-oil cake 


257 


„ chronic 




481 


,, ., caustic acids . 


217 


Persistence of the urachus . 


. 


508 


„ ,, ,, alkalies 


216 


Phallacese . •. 




225 


„ „ common salt . 


217 


Pharyngeal polypi 


. 


143 


„ „ cotton cake 


257 


Pharyngitis 




138 


„ „ ergot of rye 


223 


Pharynx, actinomycosis of the 




675 


„ „ fennel .... 


249 


„ diseases of . . . 


108, 134 


„ „ hellebore .... 


234 


Phlebitis 


. 


396 


„ ,, hemlock .... 


248 


„ accidental 




396 


,, „ lupines .... 


241 


., internal infectious 




398 


„ „ male tufts of maize . 


226 


„ umbilical 




402 


,, „ molasses refuse 


258 


„ „ of new-born animals 


399 


„ „ nitrates of potash and 




„ utero-ovarian 




398 


soda .... 


217 


Phosphorus poisoning . 




219 


„ „ poppies .... 


235 


Phthiriasis ■ 




608 


„ ,, ranunculacese , 


234 


Physiological anomalies 




567 


., „ smut of barley 


224 


Phytolaccacege .... 




229 


„ „ St. John's-wort 


246 


Pica 




158 


„ ,, sweet sorghum grass 


226 


Picked-up nails . ' . . . 




37 


„ „ tartar emetic . 


218 


Pig, cysticercus disease of the 




73 


,, „ vetches .... 


243 


„ „ „ „ cause 


of 


74 


„ ,, white loco weed 


237 


„ „ „ „ examina- 




„ „ wild chervil . 


248 


tion foi 


77 


„ carbolic acid . 


221 


symptoms 


,, colchicum .... 


256 


of 




75 


copper 


221 


„ ,, „ „ treatment 78 


,, due to food .... 


215 


„ demodecic mange in the 




644 


,, iodine 


222 


„ impetigo in the 




605 


,, iodoform . . . ■ . 


222 


,, mange in the .... 




642 


„ larkspur, in sheep . 


231 


„ pneumonia of the . 


710, 714: 


lead 


220 


„ ringworm in the 




653 


„ mercurial .... 


219 


„ urticaria in the 




656 


„ phosphorus .... 


219 


„ verrucous endocarditis of the . 


710, 713 


,, strychnine .... 


222 


Pigs, control of ... . 




725 


„ tobacco 


254 


„ ringing .... 




734 


Poke weed family 


229 


„ tonsilitis in . 




138 


Polypi of the gians penis and sheath . 


506 


„ young, castration of 




759 


„ pharyngeal .... 


143 


,, ,, inguinal hernia in 




741 


Polypodiacese 


225 


„ „ perineal hernia of 




487 


Poppies, poisoning by . 


235 


Pink family 




229 


Poppy family 


235 


Piroplasmosis .... 




416 


Post-partum paralysis .... 


461 


Plantar aponeurosis, injury to 




38 


Potato family 


252 


Plants poisonous to stock 




223 


,, pulp, eczema due to feeding 




Pleura, diseases of . 




361 


with ..... 


603 


Pleurse 




343 


Preservation of milk . . 


591 


Pleurisy, acute .... 




361 


Pricks and stabs in shoeing . 


36 


„ chronic .... 




362 


Primrose family 


251 


Plugs 




728 


Primulacege 


251 


Plum family 




236 


Probang, passing the .... 


735 


Pneumonia due to foreign bodies . 




347 


Probangs . ■ 


155 


„ „ migration of foreign 




Prolapsus and inversion of the rectum . 


743 


bodies from 


the 




Prostate 


597 


reticulum . 




348 


Prunacege 


236 


„ mechanical . 




347 


Pseudo-membranous bronchitis 


339 


„ mycosis due to aspergilli 


350 


,, laryngitis 


333 


,, of the pig . . 




710 


,, pharyngitis in 




,, simple .... 




343 


cattle 


141 


Pneumo-thorax .... 




362 


,, pharyngitis in 




Poacege 




226 


sheep 


142 


Poisoning 




213 


Pseudo pericarditis .... 


390 


., by acorns 




228 


Pseudo-rheumatism .... 


94 


,, „ aloes 




221 


,, ,, infectious, in adults 


99 


,, „ annual mercury 




256 


Psoroptic mange .... 614 


, 639 


,, „ Aragallm sj)icatvs . 




237 


Psorospermosis in calves and lambs 


271 


„ „ arsenic . 




218 


Pulmonary congestion .... 


343 



INDEX. 



Pulmonary emphysema. 
Pulse, examination of . 
Puncture, in exploration of the rumen 

of the rumen 
Purulent collections in the frontal sinus 
., ;5 maxillar} 

sinus 
., „ „ nasal sinuses 

Putrid milk . . . ... 

Pyelo-nephritis, infectious 
Pyo-pneumo-thorax 



E. 



Kachitis 

„ symptoms of 

,, treatment of 

Kagweed family .... 
Ram, castration of the . . . 751, 
,, passage of the catheter in the 
,, urethrotomy in the 
Eanunculacefe .... 

„ poisoning by . 

Rectal exploration 
Rectum, prolapsus and inversion of the 

Red milk 

Respiratory apparatus . . .311 
.J ,, examination of 

„ ,, tuberculosis of 

the . 

Rcticulitis 

Reticulum 

Retro-pharyngeal glands, tuberculosis of 

Rheumatism 

,, articular . - . 

,, infectious forms of . 

muscular . 



PAGE 

3.59 
371 
112 
737 
327 

329 
326 
589 
533 
366 



Ring-bone 

Rhiging pigs 

Ringworm 

„ in the sheep, goat, and pig 

Rot-mould family .... 

Rowels 

Rumen ...... 

,, examination of the . 
,, hernia of the 
,, impaction of the 
,, puncture of the 

Rumenitis 

Ruminants, intestinal helminthiasis in 

Rupture of the external ischio-tibial 

muscle . 

„ ,, flexor metatarsi 

Ruptures and perforations of the oeso 

phagus 



7 
256 
759 
7i9 
749 
230 
234 
116 
743 
590 
745 
311 

690 

186 

113 

696 

89 

89 

94 

92 

28 

734 

649 

653 

223 

728 

737 

110 

490 

175 

737 

186 

275 

70 
72 

157 



Salt common, poisoning by 
Sand crack . 

,, symptoms . 

„ treatment . 

Sarcoptic scabies . 
„ mange . 
Saturnism 
Scab .... 



lips, 



'■Salivary abscesses" . 


. 137 


Salivary glands, diseases of . 


. 108, 134 


Salpingitis .... 


. ooo 


Salpingo-ovaritis . 


. 555 



arsenical 
,, ,, carbolic 
,, „ Clement's bath 
„ ,, creolin bath . 
,, ,, lime and sulphur 
., „ Tessier's bath 
„ ,, tobacco and sulphur . 
„ „ Trasbot's bath 

"„ foot 

Scabies . . . . • • 
,, in sheep .... 
Scapulo-humeral joint, luxation of the 
Sclero-caseous broncho-pneumonia of 

sheep 

Scleroderma 

Sclerostoma plnfiulcola (kidney worm) 

Scorbutus 

Scrophulariacese .... 
Scrotal urethrotomy 

Scurvy 

Sebaceous or seborrhoeic eczema . 
Secretory dyspepsia 
Section of the sphincter of the teat 
Semiology of the digestive apparatus 

,, organs of circulation 
Septic metritis .... 
Septicaemia of new-born animals . 
Serous membranes, tuberculosis of 

Setons 

Sheath, inflammation of 
Sheep, acne in the 
„ aneemia in . 
,, bilharziosis in . 
',. blood poisoning in. in jSTew Zea 

land 

., caseous lymphadenitis of the 

,, catarrhal stomatitis in 

,, control of . 

,, diarrhoea in • • •. . 

,, gastro-intestinal strongylosis in 

„ larkspur poisoning in 

., oestrus larvae in the facial sinuses 

of 

„ parasitic gastro-enteritis in 

pseudo-membranous pharyngitis 

in .... . 
ringworm in the 
., scab . . ■ • • 
., scabies in . 
'., sclero - caseous broncho - pneu 

monia of . 
„ " trembling,',' or lumbar prurigo, 

in .... • 
,, ulcerative stomatitis in 
„ urinary calculi in 
,, verminous bronchitis in 
Shoeing, stabs and pricks in 
Shoulder, strain of . • • 

Simple acute bronchitis 



PAGE 

217 

34 

35 

35 

612 

641 

220 

611, 614 

632 



638 



633 
623 
624 
627 
622 
626 
623 
636 
611 
611 
63 

358 
657 
539 
104 
2.55 
748 
104 
601 
195 
770 
106 
370 
547 
406 
694 
728 
506 
606 
268 
439 

415 
453 
122 
725 
268 
263 
231 

330 

268 

142 
653 
614 
611 

358 

475 
125 
.518 
340 
36 
52 
337 



784 



INDEX. 



PAGE 

Simple acute pericarditis . . . 375 

,, coryza 319 

,, pneumonia .... 343 

,, stomatitis 121 

Sinuses, examination of . . . 312 

Skin, diseases of 599 

„ tuberculosis of the . . . 703 
Smut of barley, poisoning by . . 224 

,, family 224 

Solanacese 252 

Sole, contusions of the . . . . 31 
Sow, anatomical arrangements of the 
genital organs in the 
,, castration of the 
,, operative accidents in 
Spavin in the ox . 
Specific pericarditis 
Speculum, examination of female genital 

organs with the . 
Sphincter of the teat, contraction of the 

,, „ section of . 

Spurge family . . . . 
Stabs and pricks in shoeing . 
Sternum, hygroma of the point of the 
Stifle, hygroma of the . 

,, joint, strain of . . . 
Stink-horn family 
St. John's-wort family . 

,, poisoning by 

Stock, plants poisonous to 
Stomach, diseases of the . .110 

Stomatitis 

,, catarrhal, in sheep 

,, general catarrhal, in swine 

„ mercurial 

,, mycotic, in calves 

„ necrosing, in calves 

,, ulcerative, in swine 

,, in sheep 

Strain of the fetlock 
,, ,, hock joint 
„ „ knee .... 
,, ,, shoulder . . 
,, ,, stifle joint 
Strains of joints .... 
Strangulation, colic as a result of . 
Strawberry-shrub family 
Stricture of the oesophagus . 
Strongylosis of the abomasum in the ox 
Strychnine poisoning 

Sturdy 

Subcutaneous connective tissue, diseases 
. of the 
,. emphysema . . 659 
Submaxillary salivary gland, inflamma- 
tion of 

Sucking calves, broncho-pneumonia of 
Sugar factory pulp, diseases produced by 
Superficial glossitis 
Suppurating ostitis 
Suppurative echinococcosis . 

„ nephritis and perinephritis 

Surgical dressing for a claw . 
Suture of the vulva 

„ ,, ,, Eainard's suture 

,, ,, ,, simple suture 

., ,, ■ „ Strebel's suture 



Sweet sorghum grass, poisoning by 
Swine, acute gastric indigestion in 
„ catarrhal gastritis in . 

., fever 

„ general catarrhal stomatitis in 
„ ulcerative stomatitis in 
,, kidney worm of 
Symbiotic (chorioptic) mange 
Synovial capsule of the hock joint, dis- 
tension of . 
■ 5? 5) „ fetlock joint, 

distension of 



PAGE 
226 
185 
190 
710 
126 
127 
539 
636 

46 



48 



765 


M J, „ knee joint, dis- 


. 


765 


tension of . 


47 


768 


„ membranes, diseases of . 


45 


27 


Synovitis 


45 


375 


T. 




760 






567 


Takosis 


412 


770 


Tartar emetic, poisoning by . . 


218 


244 


TaxaceFe 


226 


36 


Taxus baccata 


226 


69 


Teat, dilatation of the orifice of the 


770 


67 


„ imperforate condition of the 


567 


54 


„ section of the sphincter of the 


770 


225 


Tendon sheaths, distension of 


48 


246 


„ ,, „ in the hock 




246 


region 


46 


223 


.5 J, „ in the region 


169 


of the knee 


49 


121 


Tendons and muscles, diseases of . 


70 


122 


Tessier's scab dip . . . . ■ 


622 


126 


Testicle, tumours of the 


594 


128 


Tetanus . . . . ' 


670 


124 


Thorax, examination of 


315 


123 


Thistle family . . . '. 


256 


127 


Third stomach, impaction of the . 


179 


125 


Thready milk .... 


589 


54 


Thrush 


124 


55 


Tobacco and sulphur dip 


626 


53 


Tobacco poisoning 


254 


52 


Tongue, actinomycosis of the 


674 


54 


Tonsilitis in pigs . . . ' . 


138 


52 


Tonsils, diseases of . . ] 


134 


167 


Torsion, castration by . 


757 


235 


„ of the uterus . , 


556 


148 


Trachea 


333 


268 


„ examination of 


314 


222 


Tracheotomy .... 


746 


467 


Trasbot's scab dip 


623 




Traumatic arthritis 


51 


599 


,, articular synovitis 


51 


738 


,, lesions .... 


568 




,, synovitis 


49 


137 


„ tendinous synovitis 


50 


356 


" Trembling," or lumbar prurigo, in sheep 


475 


259 


Trephining the facial sinuses 


745 


130 


,, frontal sinus . 


745 


29 


„ horn core 


744 


288 


„ maxillary sinus 


745 


537 


Trichiniasis-trichinosis . 


84 


730 


Trochanter of the femur, hygroma of the 


67 


768 


Truss, Lund's .... 


770 


769 


Trusses 


769 


768 


Trypanosomata, diseases produced by 


426 


769 


Tuberculosis 


682 



INDEX. 



785 



\ 



PAGE 

Tuberculosis, acute .... 704 
,, in sheep, goats and pigs 705 
,, of serous membranes . 694 
,, ,, bones and articula- 
tions . . .701 
lymphatic glands . 696 
the brain . . . 702 
, , digestive tract . 699 
,, genital organs . 700 
,, respiratory appa- 
ratus . . 690 
,, ,, skin . . .703 
Tuberculous septicasmia . . . 704 
Tumors, bone ..... BO 
,, cerebral .... 459 
,, of the gastric compartments. 202 
larynx . . . 335 
mediastinum . . 369 
nasal cavities . . 325 
ovary .... 559 
testicle . , . 594 
udder .... 585 
uterus . . . 559 

Turn-sick 467 

Tympanites, chronic .... 194 



Udder, congestion of the . . , 570 
, , cysts of the . . . . 585 
,, tuberculosis of the . .701 
,, tumors of the . , . 585 
,, verrucous papillomata of the. 586 
Ulcerative gastritis .... 191 
,, stomatitis in sheep . . 125 
,, _,, swine . . 127 
Umbilical phlebitis .... 402 
,, ,, of new-born ani- 
mals . . 899 
Umbrella-tree family .... 244 
Urachus. persistence of the . . 508 
Urethrotomy in the ox . . . 747 
„ ,, ram . . .749 
Urinary apparatus, diseases of the . 502 
,, calculi in sheep . . . 518 
,, lithiasis .... 514 



Urticaceae . 
Urticaria in the pig . 
Ustilaginaceae 
Utero-ovarian phlebitis 
Uterus, torsion of the 
, , tumors of the 



V. 



Vaccine, preparation of 

Vaccinia 

Vagina, imperforate . 

Vaginitis . 

,, acute . 
chronic 

,, contagious . 

,, croupal 
Veins, examination of , 
Verminous bronchitis in sheep and 

cattle 

Verminous conjunctivitis . 

, , ophthalmia of the ox 

Verrucous endocarditis of the pig v 
Verrucous papillomata of the udder 
Vesiculae seminales 
Vetches, poisoning by 
Viciacese 
Viscous milk 
Vulva, suture of the . 



W. 



PAGE 

229 
656 
224 
398 
556 
559 



669 
665 
560 
543 
544 
546 
545 
545 
372 

340 
662 
663 
10. 713 
586 
597 
243 
236 
589 



Warbles 


. 646 


Warts in oxen .... 


. 655 


Whitlow 


. 41 


White loco weed, poisoning by . 
Wild chervil, poisoning by 
Wounds or traumatic lesions 


. 237 

. 248 
. 568 



Yellow^ milk 
Yew family 
Yew poisoning 



590 
226 
226 



CATALOGUE OF 
WILLIAM R. JENKINS' 

Works Concerning 

HORSES, CATTLE, SHEEP, SWIHE, Etc. 

1905 



(*) Single asterisk designates New Books. 
{**) Double asterisk designates Recent Publications 



ANDERSON, "Tice in the Horse" and other papers 
on Horses and Kiding. By E. L. Anderson. Size, 
6x9, cloth, illustrated 1 75 

ABMSTEAD. " The Artistic Anatomy of the Horse." 

A brief description of the various Anatomical Struc- 
tures which may be distinguished during Life through 
the Skin, By Hugh \V. Armstead, M.D., F.K.C.S. 
With illustrations from drawings by the author. 
Cloth oblong, 10 x 12^ 3 75 

BACH, "How to Judge a Horse." A concise treatise 
as to its Qualities and Soundness ; Including Bits and 
Bitting, Saddles and Saddling, Stable Drainage, Driv- 
ing One Horse, a Pair, Four-in-hand, or Tandem, etc. 
By Capt. F.W, Bach. Size, 5x71 clo., fully illus.l 00 

{*)BANHAM, "Anatomical and Physiological Model of 
the Cow." Half life size. Composed of superposed 
plates, colored to nature, showing internal organs, 
muscles, skeleton, etc., mounted on strong boards, 
with explanatory text. Size of Model opened, 
10 ft. X 3 ft., closed 3 ft. x l^ ft 7 50 

— "Anatomical and Physiological Model of the Horse." 

Half life size. By George A, Banham, F.R.C.V.S. 
Size of Model 38 x 41 in 7 50 



^ Veterinary Catalogue of William JR. Jenkins 

BAN HAM (continued) 

— " Tables of Veterinary Posology and Therapeutics," with 
weights, measures, etc. By Geo. A. Banham, 
F.R.C.V.S. New edition. Cloth, size 4x5 1-2, 192 
pages 1 00 



BAUCHER. "Method of Horsemanship." Including 
the Breaking and Training of Horses. By 
F. Baucher 1 00 



i*)BELL, "The Teterinarian's Call Book (Perpetual)." 

By Koseoe R. Bell, D.V.S., editor of the American 
Veterinary Review. Eevised every year. 

A visiting list, that can be commenced at any time 
and used until full, containing much useful informa- 
tion for the student and the busy practitioner. 
Among contents are items concerning: Veterinary 
Drugs ; Poisons ; Solubility of Drugs ; Composition of 
Milk, Bile, Blood, Gastric Juice, Urine, Saliva; Respi- 
ration; Dentition; Temperature, etc., etc. Bound in 
flexible leather, with flap and pocket ,1 25 

BITTING. '* Cadiot's Exercises in Equine Surgery." 

See "Cadiot." 



BRADLEY. ''Outlines of Veterinary Anatomy." 

By O. Charnock Bradley, Member of the Royal Col- 
lege of Veterinary Surgeons ; Professor of Anatomy 
in the New Veterinary College, Edinburgh. 

The author presents the most important facts of 
veterinary anatomy in as condensed a form as possible, 
consistent with lucidity. 12mo. 

Complete in three parts. 

Pakt I. : The Limbs {G]oth) 125 

Pabt II. : The Trunk (paper) 1 25 

Pabt III. : The Head and Week (paper) 1 25 

The Set complete 3 25 



851-853 Sixth Avenue {cor. 48f7i St.), New York. 3 

CADIOT, " Exercises in Equine Surgery." By P. J. 

Cadiot. Translated by Prof. A. W. Bitting, D.V.M. 
Edited by Prof. A . Liautard, M.D. V.M. Size, 6 x 9^, 
cloth, illustrated 2 50 

— *' Roaring- in Horses." Its Pathology and Treatment. 

This work represents the latest development in oper- 
ative methods for the alleviation of roaring. Each 
step is most clearly defined by excellent full-page 
illustrations. By P. J. Cadiot, Professor at the 
Veterinary School, Alfort. Translated by Thos. J. 
Watt Dollar, M.K.C.Y.S., etc. Cloth, size 5 1-4x7 1-8, 
77 pages, illustrated 75 

— "Studies in Clinical Veterinary Medicine and Surgery." 

By P. J. Cadiot. Translated, edited, and supplemented 
with 49 new articles and 34 illustrations by Jno. A. W. 
Dollar, M.K.C.V.S. Cloth, size 7 x 9 3-4, 619 pages, 
94 black and white illustrations 5 25 

(*)— " A Treatise on Surgical Therapeutics of the Domestic 

Animals." By P. J. Cadiot and J. Almy. Translated 

by Prof. A. Liautard, M,D.,V.M. 

Part I. — Restraint of horses, cattle, etc. ; general 
ansBsthesia ; surgical antisepsis and asepsis ; hemo- 
stasis and cauterization ; firing. 45 illus 1 00 

Part II.— Inflammations, gangrene, foreign bodies, 
traumatic lesions, chilblains, frost bites, congela- 
tions, complications of traumatic lesions, etc. ..1 00 

Part III, — Granulations, cicatrices, mycosis, virulent 
diseases, tumors, diseases of skin and cellular 
tissue, tendons, etc 1 00 

Part IV, (completing the volume) nearly ready, 

CHAPMAN. "Manual of the Pathological Treatment 
of Lameness in the Horse," treated solely by 
mechanical means. By George T. Chapman. Cloth, 
size 6x9, 124 pages with portrait 2 00 

CHAUVEAU. "The Comparative Anatomy of the 
Domesticated Animals," By A. Chauveau. EevLsed 
by G. Fleming, F.R.C.V.S. 8vo, cloth, 585 illus., 6 25 



4 Veterinary Catalogue of William R. Jenkins 

CLARKE, "Chart of the Feet and Teeth of Fossil 
Horses." By W. H. Clarke. Card, size 9 1-2 x 12. . 25 

— *' Horses' Teeth.^' Fourth edition, re-revised, with second 
appendix. Cloth, size 5 1-4x7 1-2, 322 pp., illus. .2 50 

CLEAVELAND. "Pronouncing Medical Lexicon." 

Pocket edition. By C. H. Cleveland, M.D. Cloth, 
size 3 1-4x4 1-2, 302 pages 75 

CLEMENT, *' Veterinary Post Mortem Examina- 
tions." By A. W. Clement, V.S. The absence in the 
English language of any guide in making autopsies 
upon the lower animals, induced Dr. Clement to 
v^rite this book, trusting that it would prove of prac- 
tical value to the profession. Cloth, size 5x7 1-2, 64 
pages, illustrated 75 

{**)CO UR TEN A T, ' ' Manual of the Practice of Veterinary 
Medicine," By Edward Courtenay, V. S. Revised by 
Frederick T. G. Hobday, F.R.C.V.S. Second edition. 
Cloth, size 5 1-4 X 7 1-2, 573 pages 2 75 

COX. *' Horses : In Accident and Disease." The 

sketches introduced embrace various attitudes which 
have been observed, sach as in choking ; the disorders 
and accidents occurring to the stomach and intestines'; 
affection of the brain ; and some special forms of lame- 
ness, etc. By J. Roalfe Cox, F.R.C.V.S. Cloth, size 
6x9, 28 full page illustrations 1 50 

CURTIS. "Horses, Cattle, Sheep and Swine." By 

Geo. W. Curtis, M.S.A. Cloth, size 7 1-4 x 10, 343 
pages, 117 illustrations 2 50 

{**)DALRYMPLE. "Veterinary Obstetrics." A compen- 
dium for the use of advanced students and Practi- 
tioners. By W. H. Dalrymple, M. R. C. V. S., 
principal of the Department of Veterinary Science in 
the Louisiana State University and A. & M. College ; 
Veteiinarian to the Louisiana State Bureau of 
Agriculture, and Agricultural Experiment Stations. 
Cloth, si-.e 6x9 1-4, 162 pageg, 51 illustrations. .. 2 50 



851-853 Sixth Avenue {cor. mh St.), New York. 5 

DALZIEL, "Breaking and Training Dogs." Part I, by 
Pathfinder. Part II, by Hugh Dalziel. Cloth, 
illustrated 2 50 

— "The Collie." By Hugh Dalziel. Paper, illustrated 40 

— "The Diseases of Dogs." Causes, symptoms and treatment. * 

By Hugh Dalziel. Cloth, illustrated 1 00 

— "Diseases of Horses." Paper 40 

— " The Fox Terrier." By Hugh Dalziel. Paper, 40 ; clo.l 00 

— "The Greyhound." Cloth, illus 1 OO 

-- " The St. Bernard." Cloth, illustrated .1 00 

DANA. "Tables in Comparative Phygiology." By Prof. 
C. L. Dana, M.D. Chart, 17 x 17 26 

DANCE. "Veterinary Tablet." By A. A. Dance. Chart, 
17 X 24, mounted on linen, folded in a cloth case for 
the pocket, size 3 3-4x6 1-2. Shows at a glance the 
synopsis of the diseases of horses, cattle and dogs; 
with their cause, symptoms and cure 75 

{*)DE BRUIN. "BoYlne Obstetrics." By M. G. De Bruin 

Instructor of Obstetrics at the State Veterinary 
School in Utrecht. Translated by W. E. A. Wyman, 
formerly Professor of Veterinary Science at Clemson 
A. & M. College, and Veterinarian to the South 
Carolina Experiment Station. Cloth, size 6x9, 382 

pages, 77 illustrations 5 GO 

Synopsis of the Essential Features of the Work 

1. Authorized translation. 

2. The only obstetrical work which is up date. 

3. Written by Europe's leading authority on the subject. 

4. Written by a man who has practiced the art a lifetime. 

5. Written by a man who, on account of his eminence as 
bovine practitioner and teacher of obstetrics, was selected 
by Prof. Dr. Frohner and Prof. Dr. Bayer (Berlin and 
Vienna), to discuss bovine obstetrics both practically and 
scientifically. 

6. The only work containing a thorough differential djaj.. 
nosis of ante and post partum diseases. 



Veterinary Catalogue of William R. JenMns 



DE BRUIN, " Bovine Obstetrics " (continued) 

7. The only work doing justice to modern obstetrical 
surgery and therapeutics. 

8. Written by a man whose practical suggestions revolu- 
tionized the teaching of veterinary obstetrics even in the 
great schools of Europe. 

9. The only work dealing fully with the now no longer 
obscure contagious and infectious diseases of calves. 

10. Absolutely original and no corapilation. 

11. The only work dealing fully with the difficult problem 
of teaching obstetrics in the colleges. 

13. The only work where the practical part is not over- 
shadowed by theory. 

... A veterinarian, particularly if his location brings him in 
contact with obstetrical practice, who makes any pretence toward 
being scientific and in possession of modern knowledge upon this 
subject, will not be without this excellent work, as it is really a very 
valuable treatise.— Pro/. Roscoe B. Bell, in the American Veterinary 
Beview. 

In translating into English Professor De Bruin's excellent text- 
book on Bovine Obstetrics, Dr. Wyman has laid British and American 
veterinary surgeons and students under a debt of gratitude. The 
works represents the happy medium between the booklets which are 
adapted for cramming purposes by the student, and the ponderous 
tomes which, although useful to the teacher, are not exactly suited to 
the requirements of the everyday practitioner . . . We can strongly 
recommend the work to veterinary students and practitioners.— T^e 
Journal of Comparative Pathology and Therapeutics. 

{*)DOLLAIi, "Diseases of Cattle, Sheep, Goats and 
Swine." By G. Moussu and Jno. A, W. Dollar, 
M.R.C.V.S. Size 6x9 1-2, 785 pages, 329 illustrations 
in the text and 4 full page plates in colors., 8 75 

(**)— "A Hand-book of Horse-Shoeing," with introductory 
chapters on the anatomy and physiology of the 
horse's foot. By Jno. A. W. Dollar, M.R.C.V.S., 
with the collaboration of Albert Wheatley, F.R.C.V.S. 
Cloth, size 6x8 1-2, 433 pages, 406 illustrations . .4 75 

— ** Operative Techni(xue. " Volume 1 of '< The Practice of 

Veterinary Surgery." Cloth, size 6 3-4 x 10, 264 pages, 
272 illustrations 3 75 

— '* General Surgery.^' Volume 2 of "The Practice of Veter- 

inary Surgery." In preparation. 

(*)—" Regional Veterinary Surgery." Volume 3 of "The 
Practice of Veterinary Surgery." By Drs. Jno. A. 
W. Dollar and H. MoUer. Cloth, size 6 1-2 x 10 853 
and xvi pages, 315 illustrations 6 25 



^51-853 Sixth Avenue (cor. 4Sih St), New york. 1 

DOLLAR— (continued) 

— "Cadiot's Clinical Yeterinary Medicine and Surgery," 

See '' Cadiot." 

— "Cadiot's Roaring in Horses." 

See " Cadiot." 

DUN, "Yeterinary Medicines, their Actions and Uses." 

By Finlay Dun, V.S., late lecturer on Materia 
Medica and Dietetics at the Edinburgh Veterinary 
College, and Examiner in Chemistry to the Eoyal 
College of Veterinary Surgeons. Edited by James 
Macqueen, F.E.C. V.S. Tenth revised English edition. 
Cloth, size 6x9 3 75 

nWTEB. ^*0n Seats and Saddles." Bits and Bitting, 
Draught and Harness and the Prevention and Cure of 
Restiveness in Horses. By Francis Dwyer. Cloth, 
size 5x7, 304 pages, gilt, illustrated 1 50 

FLEMING. "Animal Plagues." Their History, Nature, 
and Prevention. By Geo. Fleming, F.R.C.V.S., etc. 
First Series. Chronological History from B.C. 1490 

to A,D. 1800. Cloth, size 6x9, 548 pages 6 00 

Second Series. Chronological History from A.D. 
1800 to 1844. Cloth, size 6x9, 539 pages 3 00 

— "The Comparatiye Anatomy of the Domesticated Animals." 

By A. Chauveau. Translated by Dr. Fleming. 
See " Chauveau." 

— ** The Contagious Diseases of Animals." Their influence on 

the wealth and health of nations and how they are to 
be combated. Paper, size 5x7 1-2, 30 pages 25 

— •* Human and Animal YariolsB." A Study in Comparative 

Pathology. Paper, size 5 1-2x8 1-2, 61 pages. . . . 25 

— *• Parasites aud Parasitic Diseases of the Domesticated 

Animals." By L. G. Neumann. Translated by 
Dr. Fleming. 

See *' Neumann." 



8 Veterinary Catalogue of William R. Jenkins 

FLEMING (continued) 

— "Operatiye Veterinary Surgery." Vol. I, by Dr. Geo. 

Fleming, M.R.C.V.S. This valuable work, one of the 
most practical treatises yet issued on the subject in 
the English language, is devoted to the common opera- 
tions of Veterinary Surgery ; and the concise descrip- 
tions and directions of the text are illustrated with 
numerous wood engravings. Cloth, size 6x9 1-4, 285 
and xviii pages, 343 illustrations 2 75 

(*)Vol. II, edited and passed through the press by 
W. Owen Williams, F.K.C.V.S. Cloth, size 6x9 1-4, 

430 and xxxvii pages, 344 illustrations 3 25 

Both volumes bound in one 5 25 

— ** Roaring in Horses," By Dr. George Fleming, 

F.R.O.V.S. Its history, nature, causes, prevention 
and treatment. Cloth, size 5 1-2x8 3-4, 160 pages, 21 
engravings, 1 colored plate 1 50 

— "Tuberculosis." From a Sanitary and Pathological Point 

of View. By Geo. Fleming, F.R.C.V.S. Paper, size 
5 1-2x8 1-2, 39 pages 25 

— "Veterinary Obstetrics." Including the Accidents and Dis- 

eases incident to Pregnancy, Parturition, and the Early 
Age in Domesticated Animals. By Geo. Fleming, 
F.B.O.V.S. Cloth, size 6x8 3-4, 758 pages, illus.6 25 

{*)QOTTHIEL. "A Manual of General Histology." 

By Wm. S. Gottheil, M.D., Professor of Pathology in 
the American Veterinary College, New York; etc., etc. 
Histology is the basis of the physician's art, as 
Anatomy is the foundation of the surgeon's science. 
Only by knowing the processes of life can we under- 
stand the changes of disease and the action of 
remedies; as the architect must know his building 
materials, so must the practitioner of medicine know 
the intimate structure of the body. To present this 
knowledge in an accessible and simple form has 
been the author's task. Second edition revised. 
Cloth, size 5 1-2 x 8, 152 pages, 68 illustrations. . .1 GO 



851-853 Sixth Avenue {cor. 4S>th St.), New Vork. » 

OBES SWELL, " The Bovine Prescriber." For the use 

of Veterinarians and Veterinary Students. Second 
edition revised and enlarged, by James B. and Albert 
Gresswell, M.R.C.V.S. Cloth, size, 5x7 1-2, 102 
pages 75 

— "The Equine Hospital Prescriber." For the use of Veter- 

inary Practitioners and Students. Third edition re- 
vised and enlarged, by Drs. James B. and Albert 
Gresswell, M.R.C.V.S. Cloth, size 5x7 1-2, 165 
pages 75 

— "Diseases and Disorders of the Horse," A Treatise on 

Equine Medicine and Surgery, being a contribution to 
the science of comparative pathology. By Albert, 
Jas. B. and Geo. Gresswell. Cloth, size 5 3-4 x 8 3-4, 
227 pages, illustrated 1 75 

— Manual of "The Theory and Practice of Equine Medicine." 

By James B. Gresswell, F.R.C.V.S., and Albert 
Gresswell, M.R.C.V.S. Second edition revised. 
Cloth, size 5 1-4x7 1-2, 539 pages 2 75 

— "Veterinary Pharmacopaeia and Manual of Comparative 

Therapy." By George and Charles Gresswell, with 
descriptions and physiological actions of medicines, 
by Albert Gresswell. Second edition revised and 
enlarged. Cloth, 6x8 3-4, 457 pages 3 50 

HASSL O CEL. * ' A Compend of Veterinary Materia Medica 
. and Therapeutics." By A. C. Hassloch, V.S., 
Lecturer on Materia Medica and Therapeutics, and 
Professor of Veterinary Dentistry at the New York 
College of Veterinary Surgeons and School of Compa- 
rative Medicine, N. Y. Cloth, size 5 1-4x7 1-2, 225 
pages 1 50 

HEATLEV. " The Stock Owner's Guide." A handy Medi- 
cal Treatise for every man who owns an ox or cow. 
By George S. Heatley, M.R.C.V.S. Cloth, size 
51-4x8, 172 pages 1 26 



10 Veterinary Catalogue of William R. Jenkins 

{**)HIJbL. " The Diseases of the Cat." By J. Woodroffe 
Hill, F.E.C.V.S. Cloth, size 5 1-4x7 1-2, 123 pages, 
illustrated 1 25 

Written from the experience of many years' prac- 
tice and close pathological research into the maladies 
to which our domesticated feline friends are liable — a 
subject which it must be admitted has not found the 
prominence in veterinary literature to which it is 
undoubtedly entitled. 

— "The Management and ^Diseases of the Dog." By J. 

Woodroffe Hill, F.R.C.V.S. Cloth, size 5x7 1-2, 
extra fully illustrated 2 00 

HINEBAUCH. "Veterinary Dental Surgery." By T. D. 

Hinebauch, M,S.V.S. For the use of Students, Prac- 
titioners and Stockmen. Cloth, size 5 l-d x 8, 256 
pages, illustrated 2 00 

SO ARE. "A Manual of Veterinary Therapeutics and 
Pharmacology." By E. Wallis Hoare, F.E.C.V.S. 
Cloth, sizes 1-4 x 7 1-4, 5 6t) pages 2 75 

OHOBDAT, " Canine and Feline Surgery," By Frederick 
T. G. Hobday, F.R.C.V.S. Cloth, 5 3-4x8 3-4, 152 
pages, 76 illustrations 2 00 

(*)— "The Castration of Cryptorchid Horses and 
the Ovariotomy of Troublesome Mares," By 

Frederick T. G. Hobday, F.R.C.V.S. Cloth, size 
5 3-4x8 3-4, 106 pages, 34 illustrations 1 75 

{**)HUNTING. The Art of Horse-shoeing. A manual 
for Horseshoers. By William Hunting, F.R.C.V.S., 
ex-President of the Royal College of Veterinary Sur- 
geons. One of the most up-to-date, concise books of 
its kind in the English language. Cloth, size 6x9 1-4, 
126 pages, 96 illustrations 1 00 

{**) JENKINS. " Model of the Horse " and " Model of the 
Cow." 

See '* Banham" 



851-853 Sixth Avenue {cor. iSth St.), New Tork. ll 

KEATING, "A New Unabridg^ed Pronouncing Diction- 
ary of Medicine." By John M. Keating, M.D., LL.D., 

Henry Hamilton and others. A voluminous and 
exhausiive hand-book of Medical and scientific 
terminology with Phonetic Pronunciation, Accentu- 
ation, Etymology, etc. With an appendix containing 
important tables of Bacilli, Micrococci, Leucomaines, 
Ptomaines ; Drugs and Materials used in Antiseptic 
Surgery ; Poisons and their antidotes ; Weights and 
Measures ; Themometer Scales ; New Officinal and 
Unofficinal Drugs, etc., etc. Cloth, 818 pages . . .5 00 

C*)KOBEBT. "Practical Toxicology for Physicians and 
Students." By Professor Dr. Kudolph Robert, 
Medical Director of Dr. Brehmer's Sanitarium for 
Pulmonary Diseases at Goerbersd©rf in Silesia (Prus- 
sia), late Director of the Pharmacological Institute, 
Dorpat, Kussia. Translated and edited by L. H. 
Friedburg, Ph.D. Authorized Edition. Practical 
knowledge by means of tables which occupy little 
space, but show at a glance similarities and differ- 
ences between poisons of the same group. Also rules 
for the Spelling and Pronunciation of Chemical Terms, 
as adopted by the American Association for the Ad- 
vancement of Science. Cloth, 6 1-2 x 10, 201 pp.. 2 50 

KOCH. "Etiology of Tuberculosis." By Dr. R. Koch. 
Translated by T. Saure. Cloth, size 6x9 1-4, 97 
pages , , 1 00 



LAMBERT. "The Oerm Theory of Disease." 

Bearing upon the health and welfare of man and the 
domesticated animals. By James Lambert, F.R.C.V.S. 
Paper, size 5 1-4x8 1-4, 26 pages, illustrated 25 



LAW. "Farmers' Teterinary Adviser." A Guide to the 
Prevention and Treatment of Disease in Domestic 
Animals. By Prof. James Law. Cloth, size 
5 1-4x7 1-2, illustrated 3 00 



12 Veterinary Catalogue of William R. Jenkins 

{**)LEGGJE. "Cattle Tuberculosis." A Practical Guide 
to the Farmer, Butcher and Meat Inspector, By T.M. 
Legge, M.A,, M.D., D.P.H., and Harold Sessions, 
F.E.C.V.S. Cloth, size 5 1-2x8 1-2, 77 pages. ... 1 00 

{**)LIAUTAIin, "Animal Castration." A concise and 
practical Treatise on the Castration of the Domestic 
Animals. The only work on the subject in the 
English language. By Alexander Liautard, M.D.,V.S. 
Having a fine portrait of the author. Tenth edition 
revised and enlarged. Cloth, size 6 1-4x7 1-2, 165 



. , . The most complete and comprehensive work on the 
subject in English veterinary literature.— -American Agri- 
culturist. 

" Cadiot's Exercises in Equine Surgery." Translated by 
Prof. Bitting and edited by Dr. Liautard. 
See " Cadiot." 

"A Treatise on Surgical Therapeutics of the Domestic 
Animals." By Prof. Dr. P. J. Cadiot and J. Almy, 
Translated by Prof. Liautard. 
See " Cadiot." 

'* How to Tell the Age of the Domestic Animal," By 

Dr. A. Liautard, M.D., V.S. Standard work upon 
this subject, concise, helpful and containing many 
illustrations. Cloth, size 5x7 1-2, 35 pages, 42 
illustrations 50 

"Lameness of Horses and Diseases of the Locomotory 
Apparatus." By A. Liautard, M.D.,V.S. This work 
is the result of Dr. Liautard's many years of experi- 
ence. Cloth, size 5 1-4x7 1-2, 314 pages 2 50 

"Manual of Operatire Teterinary Surgery." By A. 

Liautard, M.D., V.M. Engaged for years in the work 
of teaching this special department of veterinary 
medicine, and having abundant opportunities of 
realizing the difficulties which the student who 
earnestly strives to perfect himself in his calling is 
obliged to encounter, the author formed the deter- 



851-853 Sixth Avenue (cor. mh St.), New York. 13 

LIAUTARD (continued). 

mination to facilitate his acquisition of knowledge, 
and began the accumulation of material by the com- 
pilation of data and arrangement of memorandum, 
with the recorded notes of his own experience, the 
fruit of a long and extended practice and a careful 
study of the various authorities who have illustrated 
and organized veterinary literature. Cloth, size 
6 1-4 X 9, 786 pages, 563 illustrations 5 00 

— "Pellerin's Median Neurotomy in the Treatment of 

Chronic Tendinitis and Periostosis of the Fetlock." 

Translated by Dr. A. Liautard. 
See " Pellerin," 

— "Yade Mecum of Equine Anatomy.'^ By A. Liautard, 

M.D.V.S. For the use of advanced stuients and 
veterinary surgeons. Third edition. Cloth, size 
5x7 1-2, 230 pages and 10 full page illustrations of 
the arteries .2 GO 

— ZundePs " The Horse's Foot and Its Diseases." 

See '' Zundel." 

LONG» "Book of the Pig*." Its selection, Breeding, 
Feeding and Management. Cloth 4 00 

{**)IjOWE, ^* Breeding" Racehorses by the Figure 
System." Compiled by the late C. Bruce Lowe. 
Edited by William Allison, " The Special Commis- 
sioner," London Sportsman, Hon. Secretary Sporting 
League, and Manager of the International Horse 
Agency and Exchange. With numerous fine illustra- 
tions of celebrated horses. Cloth, size 8 x 10, 262 
pages • 7 50 

LUDJLOW, "Science in the Stable"; or How a Horse 
can be Kept in Perfect Health and be Used Without 
Shoes, in Harness or under the Saddle. With the 
Reason Why, Second Edition. By Jacob R. Ludlow, 
M.D. Late Staff Surgeon, U. S, Army. Paper, size 
41-2x5 3-4, 166 pages 50 



14 Veterinary Catalogue of William R. Jenkins 

L UP TON. "Horses: Sound and Unsound," with 
Law relating to Sales and Warranty. By J. Irvine 
Lupton, F.R.C.VS. Cloth, size 5 3-4 x 7 1-2, 217 
pages, 28 illustrations 1 25 

MAGNEB. "Standard Horse and Stock Book." By 

D. Magner. Comprising over 1,000 pages, illustrated 
witii 1756 engravings. Leather binding 6 CO 

McBBIDE. "Anatomical Outlines of the Horse." By 

J. A. McBride, M R C.V.S. Second edition revised 
and enlarged. Cloth, size 5 1-4x7 1-4, illus 2 50 

{*)M'FAI>TEAN, "Anatomy of the Horse." Second 
edition completely revised. A Dissection Guide. 
By John M'Fadyean, M.B., B.Sc, F.E.S.E. Cloth, 

size 6 X 8 3 4, 388 pages, illustrated S 50 

This book is intended for Veterinary students, and 
offers to them in its 48 full-page colored plates, 
54 illustrations and excellent text, a valuable and 
practical aid in the study of Veterinary Anatomy, 
especially in the dissecting room. 

— " Comparative Anatomy of the Domesticated Animals." 

By J. M'Fadyean. Profusely illustrated, and to be 

issued in two parts. 

Part I— Osteology, ready. Size 5 1-2x8 1-2, 166 

pages, 132 illustrations. Paper, 2 50; cloth 2 75 

(Part II in preparation.) 

MILLS. "How to Keep a Dog in the City.'' By 

Wesley Mills, M.D., D.V.S. It tells how to choose^ 
manage, house, feed, educate the pup, how to keep him 
clean and teach him cleanliness. Paper, size 5x7 1-2, 
40 pages 25 

OMOLLEB — DOLLAR. *' Regional Veterinary 

Surgery." See '' Dollar.'' 

MOHLEB. "Tandbook of Meat Inspection." By Robert 
Ostertag, . M.D. Translated by Earley Vernon 
Wilcox, A.M., Ph.D. With an . introduction by 
John B. Mohler, V.M.D., AM. See '* Ostertag." 



851-853 Sixth Avenue {cor. mh St.), New York. 15 

MOSSEI^MAJS-LIENAUX, *' Manual of Veterinary 
Microbiology," By Professors Mosselman and 
Lienaux, Nat. Veterinary College, Cureghem, Belgium. 
Translated and edited by E. K. Dinwiddle, Professor 
of Veterinary Science, College of Agriculture, Arkansas 
State University. Cloth, size 5 1-2 x 8, 342 pages, 
illustrated ■ 2 00 

{*)3IOUSSU. "Diseases of Cattle, Sheep, Goats and 
Swine." By G-. Moussu and Jno. A. W. Dollar, 
M.E.C.V.S. 

See " Dollar." 

NEUMANN, "A Treatise on Parasites and Parasitic 
Diseases of the Domesticated Animals." A work 
to which the students of human or veterinary medi- 
cine, the sanitarian, agriculturist or breeder or rearer 
of animals, may refer for full information regarding 
the external and internal Parasites — vegetable and 
animal — which attack various species of Domestic 
Animals. A Treatise by L= G. Neumann, Professor 
at the National Veterinary School of Toulouse. 
Translated and edited by George Fleming, C. B., L.L. 
D.,F.R.O.V.S. Cloth, size 6 3.4 x 10, 873 pages, 365 
illustrations 7 50 

NOCAUD, " The Animal Tuberculoses, and their Relation 
to Human Tuberculosis." By Ed. Nocard, Prof, of the 
Alfort Veterinary College. Translated by H. Scurfield, 
M.D. Ed., Ph. Camb. Cloth, 5x7 1-2, 143 pages . . 1 GO 
Perhaps the chief interest to doctors of human 
medicine in Professor Nocard's book lies in the 
demonstration of the small part played by heredity, 
and the great part played by contagion in the propa- 
gation of bovine tuberculosis. It seems not unreason- 
able to suppose that the same is the case for human 
tuberculosis, and that, if the children of tuberculous 
parents were protected from infection by cohabitation 
or ingestion, the importance of heredity as a cause of 
the disease, or even of the predisposition to it, would 
dwindle away into insignificance. 



16 Veterinary Catalogue of William R, Jenkins 

OSTEBTAG. "Handbook of Meat Inspection." By 

Robert Ostertag, M.D. Authorized Translation by 
Earley Vernon Wilcox, A.M., Ph.D. With an intro- 
duction by John R. Mohler, V.M.D., A.M. The work 
is exhaustive and authorative and has at once become 
the standard authority upon the subject Cloth, size 
6 3-4x9 3-4, 920 pages, 260 illustrations and 1 colored 
plate 7 50 

PAIjLIN, "A Treatise on Epizootic Lymphangitis." By 

Capt. W. A. Pallin, r,R,C.V.S. In this work the 
author has endeavored to combine his own experience 
with that of other writers and so attempts to give a 
clear and complete account of a subject about which 
there is little at present in English veterinary litera- 
ture. Cloth, size 5 3-4x8 1-2, 90 pages, with 17 fine 
full page illustrations 1 25 

PJEGLEU, "The Book of the Goat." Third edition re- 
written and enlarged. Cloth, 223 pages, illus 1 75 

rELLEBIN. "Median Neurotomy in the Treatment 
of Chronic Tendinitis and Periostosis of the Fetlock. " 

By C. Pellerin, late repetitor of Clinic and Surgery to 
the Alfort Veterinary School. Translated, with Addi- 
tional Facts Relating to It, by Prof. A. Liautard, M.D., 
V.M. Having rendered good results when performed 
by himself, the author believes the operation, which 
consists in dividing the cubito-plantar nerve and in 
excising a portion of the peripherical end, the means 
of improving the conditions, and consequently the 
values of many apparently doomed animals. Agricul- 
ture in particular will be benefited. 

The work is divided into two parts. The first covers 
the study of Median Neurotomy itself ; the second, 
the exact relations of the facts as observed by the 
author. Boards, 6x9 1-2, 61 pages, illustrated. . 1 00 

PETBBS. " A Tuberculous Herd— Test with Tuher- 
culin." By Austin Peters, M. R. C. V. S., Chief 
Inspector of Cattle for the New York State Board of 
Health during the winter of 1892-93. Pamphlet. ... 25 



851-853 Sixth Avenue {cor. 48th St.), New York. 17 

REYNOLDS, "An Essay on the Breeding and Manage- 
ment of Draught Horses." By K. S. Eeynolds, 
M.R.C.V.S. Cloth, size 5 1-2x8 3-4, 1C4 pages. .1 40 

BOBEBGE. "The Foot of the Horse," or Lameness 
and all Diseases of the Feet traced to an Unbalanced 
Foot Bone, prevented or cured by balancing the foot. 
By David Eoberge. Cloth, size 6x9 1-4, 308 pages, 
illustrated 5 00 

SEW ELL,. " The Examination of Horses as to Sound- 
ness and Selection as to Purchase." By Edward 
Sewell, M.R.C.V.S. Paper, size 51-2x8 1-2, 86 pages, 
illustrated with 8 plates in color 1 50 

— It is a great advantage to the business man to 
know something of the elements of law, and nobody 
ought either to buy or own a horse who does not know 
something about the animal. That something this book 

gives, and gives in a thoroughly excellent way 

—Our Animal Friends . 

SMITH, **A Manual of Yeterinary Physiology." By 

Veterinary Captain F. Smith, M.R.C.V.S. Author of 
♦* A Manual of Veterinary Hygiene." 

Throughout this manual the object has been to con- 
dense the information as much as possible. The 
broad facts of the sciences are stated so as to render 
them of use to the student and practitioner. In this 
second edition — rewritten — the whole of the Nervous 
System has been revised, a new chapter dealing with 
the Development of the Ovum has been added together 
with many additional facts and illustrations. About 
one hundred additional pages are given. Second 
edition, revised and enlarged. Cloth, size 6x8 3-4, 
673 pages, 102 illustrations , 3 7S 

— "Manual of Yeterinary Hygiene." Second edition revised. 
Cloth, size 5 1-4x7 1-2, 477 pages, 93 illus 2 75 

{•*)STBANGEWAY, "Veterinary Anatomy." Edited by 
I. Vaughan, F.L.S., M.R.C.V.S. New edition revised. 
Cloth, size 6 1-4x9 1-2, 625 pages, 224 illus 5 00 



18 Veterinary Catalogue of William R. Jenkins 

SUSSDORF. <^ Six Large Colored Wall Diagrams." By 

Prof. Sussdorf, M.D. (of GOttingen). Text translated 
by Prof. W. Owen Williams, of the New Veterinary 
College, Edinburgh. Size, 44 inches by 30 inches. 

1.— Horse. 4.— Ox, 

2.— Mare. 5.— Boar and Sow. 

3.— Cow. 6.— Dog and Bilclu 
The above are printed in eight or nine colors. 
Showing the position of the viscera in the large 
cavities of the body. 
Price, unmounted 1 75 each 

" mounted on linen, with roller 3 50 ** 

r*)THOMFSON, ''Elementary Lectures on Teterinary 
Science." For agricultural students, farmers and 
stock keepers. By Henry Thompson, M.R.C.V.S., 
lecturer on Veterinary Science at the Aspatria Agri- 
cultural College, England. It is complete yet concise 
and an up-to-date book. Cloth, 397 pp., 51 illu8..3 75 

VAN MATEn. <'A Text Book of Veterinary Oph- 
thalmology." By George G. Van Mater, M.D., 
D.V.S., Professor of Ophthalmology in the American 
Veterinary College ; Oculist and Aurist to St. Martha's 
Sanitarium and Dispensary; Consulting Eye and Ear 
Surgeon to the Twenty-sixth Ward Dispensary ; Eye 
and Ear Surgeon, Brooklyn Eastern District Dispen- 
sary, etc. Illustrated by one chromo lithograph plate 
and 71 engravings. Cloth, 6x9 1-4, 151 pages.. .3 00 

... We intend to adopt this valuable work as a text 
book.— i^. J. Creely, D.V.S., Dean of the San Francisco 
Veterinary College. 

VETERINARY DIAGRAMS in Tabular Form. 

Size, 28| in. x 22 inches. Price per set of five 4 00 

Mounted an d folded in case 7 80 

Mounted on roller and varnished ID" GO 

No. 1. "The External Form and Elementary Ana- 
tomy of the Horse." Eight colored illustrations — 
1. External regions ; 2. Skeleton ; 3. Muscles (Superior 
Layer) ; 4. Muscles (Deep Layer) ; 5. Respiratory Ap- 



851-853 Sixth Avenue {cor. 4:8th St.), New York. 19 

VETERINAEY DIAGKAMS (continued). 

paratus ; 6. Digestive Apparatus ; 7. Circulatory Ap- 
paratus ; 8. Nerve Apparatus ; with letter-press descrip- 
tion 1 25 

Mounted on roller and varnished 2 25 

No. 2. "The Age of Domestic Animals." Forty-two 
figures illustrating the structure of the teeth, indicat- 
ing the Age of the Horse, Ox, Sheep, and Dog, with 

full description 75 

Mounted on roller and varnished 2 00 

No. 3. «' The Unsoundness and Defects of the Horse." 

Fifty figures illustrating— 1. The Defects of Confor- 
mation; 2. Defects of Position ; 3. Infirmities or Signs 
of Disease ; 4. Unsoundnesses ; 5. Defects of the Foot ; 

with full description 75 

■Mounted on roller and varnished 2 00 

No. 4. ".The Shoeing of the Horse, Mule and Ox." 

Fifty figures descriptive of the Anatomy and Physio- 
logy of the Foot and of Horse-shoeing 75 

Mounted on roller and varnished 2 00 



No. 5. "The Elementary Anatomy, Points, and But- 
cher's Joints of the Ox." Ten colored illustrations 
—1. Skeleton; 2. Nervous System; 3. Digestive 
System (Eight Side) ; 4. Kespiratory System ; 5. Points 
of a Fat Ox ; 6. Muscular System ; 7. Vascular System; 
8. Digestive System (I^eft Side) ; 9. Butcher's Sections 
of a Calf ; 10. Butcher's Sections of an Ox ; with full 

description 1 25 

Mounted on roller and varnished 2 25 



WAIjLEY, "Four Boylne Scourges." (Pleuro-Pneumonia, 
Foot and Mouth Disease, Cattle Plague and 
Tubercle). By Thomas Walloy, M.K.C.V.S. With 
an Appendix on the Inspection of Live Animals and 
Meat. Quarto, cloth 6 40 



S0&?" 



20 Veterinary Catalogue of William R. Jenkins 

WALLEY (continued). 

(*)— "A Practical Guide to Meat Inspection." By 

Thomas Walley, M.R.C.V.S., late principal of the 
Edinburgh Royal (Dick) Veterinary College; Pro- 
fessor of Veterinary Medicine and Surgery, etc. 
Fourth Edition, thoroughly revised and enlarged 
by Stewart Stockman, M.R.C.V.S., Professor of 
Pathology, Lecturer on Hygiene and Meat Inspection 
at Dick Veterinary College, Edinburgh. Cloth, size 
5 1-2x8 1-4, with 45 colored illus., 295 pages 3 00 

An experience of over 30 years in his profession 
and a long official connection (some sixteen years) 
with Edinburgh Abattoirs have enabled the author to 
gather a large store of information on the subject, 
which he has embodied in his book. 

While Dr. Stockman is indeed indebted to the 
old for much useful information, tJiis up-to- 
date work will hardly be recognized as the old 
" Walley 's Meat Inspection." 



WILCOX. ** Handbook of Meat Inspection." By Robert 
Ostertag, M.D. 

See " Ostertag.'* 



WILLIAMS, "Principles and Practice of Veterinary 
Medicine." Author's edition, entirely revised and 
illustrated with numerous plain and colored plates. 
By W. Williams, M.R.O.V.S. Cloth, size 5 3-4x8 3-4, 
868 pages 7 50 



— "Principles and Practice of Teterinary Surgery." 

Author's edition, entirely revised and illustrated 
with numerous plain and colored plates. By W. 
Williams, M.R.C.V.S. Cloth, size 6 1-2x9 1-4, 756 
pages .7 50 



851-853 Sixth Avenue (cor. mh St.)y J^ew York 2J 

THE MOST COMPLETE, PROGRESSIVE AND 
SCIENTIFIC BOOK ON THE SUBJECT IN 
THE ENGLISH LANGUAGE 

(*) WINSL O W, * 'Veterinary Materia Medica and Therapeu- 
tics." By Kenelm Winslow, B.A.S., M.D.V., M.D., 

(Harv.) ; formerly Assistant Professor of Therapeutics 
in the Veterinary School of Harvard University ; 
Fellow of the Massachusetts Medical Society ; Surgeon 
to the Newton Hospital, etc. 

Second Edition Revised. 

Cloth, size 6 1-4x9 1-4, 761 pages 6 00 

Your letter received and I am pleased to know that we are to 
have an American Materia Medica.— J". H. Wattles, Sr., M.D., D.V.S., 
The Western Veterinary College, Kansas City, Mo. 

. . . Am delighted "\yith it. It is remarkably correct, complete 
and up-to-date and is hound to supersede any other work on the same 
subject heretofore before the profession. 

No practitioner's library is complete without it and it will be 
Indispensable for students, as it does away with the necessity of their 
having a number of collateral books on the subject. 

It will be adopted as the text book in the Chicago Veterinary 
College.— Dr. E. L. Quitman, Chicago Veterinary College. 

. . . The book is of admirable merit and full of valuable informa- 
tion from beginning to end, very explicit, rich and interesting, and 
should be in the hands of every student as well as practitioner of the 
art of Veterinai-y MeAicine.— Thurston Miller, M.D., Professor of 
Materia Medica, Therapeutics and Chemistry, San Francisco Veteri- 
nary College. 

I consider it the only work on materia medica and therapeutics 
suitable to the American veterinary practitioner. It deserves a wide 
distribution among veterinarians. I have recommended it to my 
students.— Jo?()i J. Repp, V.M.D., Iowa State College, Ames, Iowa. 



22 Veterinary Catalogue of Wiltiam R. Jenkins. 

{*)WYMAN, "Bovine Obstetrics." By M. G. De Bruin. 
Translated by W. E. A. Wyman, M.D.V.,V.S. 
See also " De Bruin." 

(*)— "Catechism of the Principles of Yeterinary Surgery." 

By W. E. A. Wyman, M.D.V.,V.S. Cloth, size 6 x 9, 

317 pages 3 50 

Coucerniu^ this new >vork atteiitiou is called to the 
following points: 

1.— It discusses tlie subject upon the basis of veterinary investigations. 

2. — It does away with works on human pathology, histology, etc. 

3. — It explains each question thoroughly both Irom a scientific as well 

as a practical point of A-iew. 
4. — It is writen by one knowing the needs of the student. 
5.— It deals exhaustively with a chapter on tumors, heretofore utterly 

neglected in veterinary pathology. 
6.— The only work in English specializing the subject. 
7.— The only work thoroughly taking into consideration American as 

well as European investigations. 
8.— Offering practical hints which have not appeared in print, the 

result of large city and country practice. 

(*•)— " The Clinical Diagnosis of Lameness in the Horse." 

By "W. E. A. Wyman, D.V.S., formerly Professor of 
Veterinary Science, Clemson A. & M. College, and 
Veterinarian to the South Carolina Experiment 
Station. Cloth, size 6x9 1-2, 182 pp., 32 illus. . . .2 50 

(•)— *' Tihio-peroneal Neurectomy for the Relief of Spavin 

Lameness." By W. E. A. Wy/nan, M.D.V., V.S. 

Boards, size 6 x 9, 30 pages, illustrated 50 

Anvone wanting to perform this operation should procure 
this little treatise ; he will find it of considerable help.— T/ie 
Veterinary Journal. 

ZUNDEL, "The Horse's Foot and Its Diseases." By 

A. Zundel, Principal Veterinarian of Alsace Lorraine. 
Translated by Dr. A. Liautard, V.S. Cloth, size 
5x7 3-4, 248 pages, illustrated 2 00 

ZJJILL, * 'Typhoid Fever; or Contagious Inflnenxa 
in the Horse." By Prof. W. L. Zuill, M.D.,D.V.S. 
Pamphlet, size 6x9 1-4, 29 pages 25 



Any book sent prepaid for the price 

WILLIAH R. JENKINS, 

851 and 853 Sixth Avenue, NEW YORK. 



I 



AUG 14 1909 



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LIBRARY OF CONGRESS 



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